| Tesheika Navoy Boomer, FNP, PMHNP | |
|
203 Crockett Ridge Ct E, Richlands, NC 28574-7471 | |
| (910) 650-6592 | |
| (910) 597-1689 |
| Full Name | Tesheika Navoy Boomer |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 203 Crockett Ridge Ct E, Richlands, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598392375 | NPI | - | NPPES |
| 5013170 | Other | NC | NC STATE LICENCES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | F12190403 (North Carolina) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 2022091499 (North Carolina) | Secondary |
| Entity Name | Eastern Psychiatric & Behavioral Specialists Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558426007 PECOS PAC ID: 1759278336 Enrollment ID: O20040228000370 |
| Entity Name | Lifesource Of North Carolina |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811286156 PECOS PAC ID: 7416132428 Enrollment ID: O20110505000743 |
| Entity Name | Signify Health Medical Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191001003503 |
| Mailing Address | Practice Location Address |
|---|---|
| Tesheika Navoy Boomer, FNP, PMHNP 203 Crockett Ridge Ct E, Richlands, NC 28574-7471 Ph: (910) 650-6592 | Tesheika Navoy Boomer, FNP, PMHNP 203 Crockett Ridge Ct E, Richlands, NC 28574-7471 Ph: (910) 650-6592 |
Debra J Jones, PNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8399 Richlands Hwy, Richlands, NC 28574 Phone: 910-324-7268 Fax: 910-324-7273 | |
Tina Reagan, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 107 S Wilmington St, Richlands, NC 28574 Phone: 910-324-7268 Fax: 910-324-7273 |