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General NPI Number Information
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NPI Number | 1861559098
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Entity Type | Individual
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Provider Name | TERESA T. KEVIL APRN, BC, ANP
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 1233 SPRAGUE ST
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City | SHREVEPORT
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State | LA
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Zip | 71101-3349
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Country | US
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Telephone | 318-227-2912
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Fax |
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Provider Business Mailing Address
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Address Line | 68 COLONY BND #195
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City | SHREVEPORT
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State | LA
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Zip | 71115-3159
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Country | US
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Telephone | 318-677-3086
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Fax | 318-677-3068
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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 | RN032673 - APO1989
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License Number State | LA
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