Provider Demographics
NPI:1538314901
Name:BURNS, TERESA ANN (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:BURNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MOHAWK TRL
Mailing Address - Street 2:
Mailing Address - City:FOSS
Mailing Address - State:OK
Mailing Address - Zip Code:73647-9011
Mailing Address - Country:US
Mailing Address - Phone:580-562-4529
Mailing Address - Fax:
Practice Address - Street 1:70 N 31ST ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-9116
Practice Address - Country:US
Practice Address - Phone:580-323-6021
Practice Address - Fax:580-323-5635
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0076724163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse