Individual provider Active NPI

Teresa Vettese, APRN

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1417705013
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704340266 Issued in MI
Practice address
30277 Woodward Ave
Royal Oak, MI 48073-0911
Phone
(586) 604-0006
NPI assigned
May 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704340266 MI Primary

Addresses

Primary practice location

30277 Woodward Ave
Royal Oak, MI 48073-0911

Mailing address

1506 Whitcomb Ave
Royal Oak, MI 48073-4738
Phone (586) 604-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704340266MIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1417705013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 WHITCOMB AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734738",
            "telephone_number": "586-604-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30277 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730911",
            "telephone_number": "586-604-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTESE",
        "first_name": "TERESA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704340266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.