Provider Demographics
NPI:1689868853
Name:MAPE, TERESA (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MAPE
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 1:201 PLAGEMAN BLDG
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97331-8567
Mailing Address - Country:US
Mailing Address - Phone:541-737-2724
Mailing Address - Fax:541-737-9694
Practice Address - Street 1:201 PLAGEMAN BLDG
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331-8567
Practice Address - Country:US
Practice Address - Phone:541-737-2724
Practice Address - Fax:541-737-9694
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health