Provider Demographics
NPI:1679619985
Name:BORREMANS, TERESA L (RN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:BORREMANS
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 1:1024 S MUSKOGEE AVE
Mailing Address - Street 2:PO BOX 1247
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-4734
Mailing Address - Country:US
Mailing Address - Phone:918-456-8399
Mailing Address - Fax:918-456-8773
Practice Address - Street 1:1024 S MUSKOGEE AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-4734
Practice Address - Country:US
Practice Address - Phone:918-456-8399
Practice Address - Fax:918-456-8773
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0032077163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health