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Individual

TERESA DAVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
2122 MANCHESTER EXPY, COLUMBUS, GA 31904-6878
(706) 320-3128
(706) 320-3230
Mailing address
PO BOX 8147, COLUMBUS, GA 31908-8147
(706) 320-3128
(706) 320-3230

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN172048
GA
363LG0600X
Gerontology Nurse Practitioner
RN172048
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003158599A
GA
05
172474
AL
Enumeration date
03/19/2015
Last updated
07/30/2015
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