Individual
MR. HARRY RAFAEL SEVILLA ABILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C, CRNA, MSN
Contact information
Practice address
310 NORTH DAVIS STREET, LAGRANGE, GA 30240
(706) 812-4068
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN181018
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130882
TX
367500000X
Certified Registered Nurse Anesthetist
RN181018
GA
Other
Enumeration date
07/20/2006
Last updated
01/12/2022
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