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General NPI Number Information
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NPI Number | 1033292248
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Entity Type | Individual
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Provider Name | TEDDI POCHE' WILLIS APRN, FNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 2305 RICHARD ST
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City | ABBEVILLE
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State | LA
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Zip | 70510-3223
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Country | US
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Telephone | 337-892-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 109 TURFWAY DR
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City | LAFAYETTE
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State | LA
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Zip | 70508-5609
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Country | US
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Telephone | 337-371-0362
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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 | APO3138
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License Number State | LA
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