Healthcare Provider Details

I. General information

NPI: 1730688110
Provider Name (Legal Business Name): TERESA DAVIS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RIVER RIDGE DR
ASHEVILLE NC
28803-1299
US

IV. Provider business mailing address

47 WINTERWIND DR
ASHEVILLE NC
28803-9606
US

V. Phone/Fax

Practice location:
  • Phone: 828-298-6350
  • Fax:
Mailing address:
  • Phone: 239-209-2760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9210035
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012956
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: