Healthcare Provider Details

I. General information

NPI: 1205169273
Provider Name (Legal Business Name): TERESA ANN DOWLING FNP-BC, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA ROTH-DOWLING

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4972 COUNTY ROAD 38
FORT CALHOUN NE
68023-5054
US

IV. Provider business mailing address

4972 COUNTY ROAD 38
FORT CALHOUN NE
68023-5054
US

V. Phone/Fax

Practice location:
  • Phone: 402-641-8822
  • Fax:
Mailing address:
  • Phone: 402-641-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114254
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG123175
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA123175
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: