Provider Demographics
NPI:1639535537
Name:DORSEY, TEAGAN RAE (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:TEAGAN
Middle Name:RAE
Last Name:DORSEY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 COUNTY STREET 2600
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73047
Mailing Address - Country:US
Mailing Address - Phone:405-545-0727
Mailing Address - Fax:
Practice Address - Street 1:304 S 29TH STREET
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018
Practice Address - Country:US
Practice Address - Phone:405-896-8058
Practice Address - Fax:844-965-9881
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK102643363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse