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General NPI Number Information
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NPI Number | 1013023936
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Entity Type | Individual
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Provider Name | TERESA A KOWALCZYK-VITOUS DNP.ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 10155 OKEECHOBEE BLVD
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-1404
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Country | US
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Telephone | 561-204-2349
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Fax |
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Provider Business Mailing Address
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Address Line | 15097 93RD ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-1798
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Country | US
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Telephone | 561-714-7432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3077902
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License Number State | FL
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