Individual
TERESA IVEY LANGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2814 14TH AVE SE, RUSKIN, FL 33570-5471
(813) 349-7800
(813) 349-7861
Mailing address
13110 ELK MOUNTAIN DR, RIVERVIEW, FL 33579-7182
(813) 349-7568
(813) 349-7561
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP3166662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302065700
—
FL
Enumeration date
08/14/2008
Last updated
09/11/2013
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