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General NPI Number Information
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NPI Number | 1235523044
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Entity Type | Individual
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Provider Name | TERESA DAVILA NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 2122 MANCHESTER EXPY
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City | COLUMBUS
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State | GA
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Zip | 31904-6878
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Country | US
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Telephone | 706-320-3128
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Fax | 706-320-3230
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Provider Business Mailing Address
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Address Line | PO BOX 8147
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City | COLUMBUS
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State | GA
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Zip | 31908-8147
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Country | US
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Telephone | 706-320-3128
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Fax | 706-320-3230
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN172048
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN172048
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License Number State | GA
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