Provider Demographics
NPI:1700800869
Name:FLOWERETTE, THERESA ANNE (ARNP, NP-C)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANNE
Last Name:FLOWERETTE
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-5911
Mailing Address - Country:US
Mailing Address - Phone:918-287-9112
Mailing Address - Fax:918-287-9113
Practice Address - Street 1:1230 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-5911
Practice Address - Country:US
Practice Address - Phone:918-604-5108
Practice Address - Fax:918-287-9113
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0070154163WM0705X
OK70154363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical