Provider Demographics
NPI:1053367193
Name:HARRISON, TEENA JO (ARNP)
Entity type:Individual
Prefix:MS
First Name:TEENA
Middle Name:JO
Last Name:HARRISON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N GLEBE RD STE 700
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-4173
Mailing Address - Country:US
Mailing Address - Phone:702-689-1545
Mailing Address - Fax:
Practice Address - Street 1:1315 CREEKSHIRE WAY APT 326
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3097
Practice Address - Country:US
Practice Address - Phone:702-689-1545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC004060363LF0000X
VA0024173113363LF0000X
GANP000162363LF0000X
FLAPRN11015163363LF0000X
NVAPN001047363LF0000X
TX1060247363LF0000X
TN80350363LF0000X
FL2883852363LG0600X
NC5008519363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology