Teisha N. Pink-Gonzalez

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024182461 Issued in VA

Practice address

26317 West Washington St
Petersburg, VA 23803

Phone

(804) 524-7372

NPI assigned

Sep 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1609545847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HIRAM DAVIS MEDICAL CENTER",
            "address_2": "26317 WEST WASHINGTON ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "804-524-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 WEST WASHINGTON ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "804-524-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINK-GONZALEZ",
        "first_name": "TEISHA",
        "middle_name": "N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix-N-Peace Acr, Inc.
• Phoenixmides LLC
• Physician Associates LTD
• Chitra Pidaparti, PH.D.
• Joshua Paul Pidcoe
• Jeffrey Hall Pinsky, DPM
• Marc Jay Pinsky, D.P.M.
• Angel Piper, LCSW
• John Shaquille Poitier
• Carole Ann Pollard, CPHT

• Family Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.