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General NPI Number Information
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NPI Number | 1770048894
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Entity Type | Individual
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Provider Name | TERESA O'CONNELL ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/02/2019
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 10516 SAWMILL RD # 41
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City | POWELL
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State | OH
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Zip | 43065-7299
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Country | US
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Telephone | 614-401-6363
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Fax |
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Provider Business Mailing Address
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Address Line | 10516 SAWMILL RD # 41
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City | POWELL
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State | OH
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Zip | 43065-7299
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Country | US
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Telephone | 614-557-7394
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | APRN.CNP.13182
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License Number State | OH
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