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General NPI Number Information
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NPI Number | 1053839167
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Entity Type | Individual
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Provider Name | ESTHER O TELLA NP
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Gender | Female
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 6095 MARSHALEE DR STE 130
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City | ELKRIDGE
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State | MD
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Zip | 21075-6082
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Country | US
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Telephone | 251-901-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 3431 FOREST PEAK WAY
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City | MARIETTA
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State | GA
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Zip | 30066-1772
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Country | US
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Telephone | 770-608-9127
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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 | RN202640
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC003174
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License Number State | MD
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