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General NPI Number Information
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NPI Number | 1083732978
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Entity Type | Individual
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Provider Name | THERESA O. OPARAH FNP
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9721 ORMSBY STATION RD STE 106
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City | LOUISVILLE
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State | KY
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Zip | 40223-4095
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Country | US
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Telephone | 502-423-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WINTERBERRY RDG
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City | FAIRBURN
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State | GA
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Zip | 30213-3476
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Country | US
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Telephone | 404-384-3996
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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 | RN084496
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License Number State | GA
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