Individual ProviderTeresa L WainscottPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address221 Michigan St NE Ste 300, Grand Rapids, MI 49503-2537(616) 459-7258PECOS EnrollmentBased on the most recent information from CMS, provider Teresa L Wainscott does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:37 AM.Profile DetailsProvider ID1417907874Provider TypeIndividualFull NameWainscott, Teresa LCredentialPAGenderFemaleSole ProprietorNoEnumeration Date5/10/2006Last Updated5/1/2023Contact InformationPractice LocationPractice Address221 Michigan St NE Ste 300, Grand Rapids, MI 49503-2537Phone(616) 459-7258Fax(616) 459-5215Mailing LocationMailing Address100 Michigan St NE, Mc 845, Grand Rapids, MI 49503-2560PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense5601001788Michigan