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Individual

TERESA CIRVELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
511 LONGWORTH BLVD, DUNCANVILLE, TX 75116-2505
(817) 201-5760
Mailing address
511 LONGWORTH BLVD, DUNCANVILLE, TX 75116-2505

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
635972
TX
363L00000X
Nurse Practitioner
Primary
AP140774
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32059450257
TEXAS SALES AND USE TAX PERMIT
TX
Enumeration date
10/24/2018
Last updated
05/22/2019
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