TERESA MARIE FUDGE RN NPI 1144366683

NPI Information

NPI: 1144366683
Provider Name: TERESA MARIE FUDGE, RN
Classification: Registered Nurse - 163WP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
412 SW 12TH AVE
PORTLAND, OR
ZIP 97205
Phone: (503) 228-7134
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Teresa Marie Fudge, RN is a psychiatric/mental health registered nurse in Portland, OR. Teresa Marie Fudge, RN NPI is 1144366683. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

412 SW 12TH AVE
PORTLAND, OR
ZIP 97205-329
Phone: (503) 228-7134

The enumeration date for this NPI number is 1/30/2007 and was last updated on 1/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101YM0800X	Counselor	Mental Health	OREGON	No
2	163WA0400X	Registered Nurse	Addiction (Substance Use Disorder)	OREGON	No
3	163WC1500X	Registered Nurse	Community Health	OREGON	No
4	163WP0808X	Registered Nurse	Psychiatric/Mental Health	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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