Provider Demographics
NPI:1902636368
Name:ALVERSON, TERESA L (NP)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:ALVERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 MISTLETOE LN
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-9542
Mailing Address - Country:US
Mailing Address - Phone:864-243-7003
Mailing Address - Fax:
Practice Address - Street 1:322 MISTLETOE LN
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-9542
Practice Address - Country:US
Practice Address - Phone:864-243-7003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28159363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner