Healthcare Provider Details

I. General information

NPI: 1912849183
Provider Name (Legal Business Name): TERESA VANESSA ARANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA VANESSA ALCANTAR

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 WRIGHT AVE
ROBERTA GA
31078-4945
US

IV. Provider business mailing address

254 WRIGHT AVE
ROBERTA GA
31078-4945
US

V. Phone/Fax

Practice location:
  • Phone: 229-384-5576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP295830
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: