Healthcare Provider Details

I. General information

NPI: 1780787937
Provider Name (Legal Business Name): TERESA R BUOL APRN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA R SEXE BSN, RN

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 NICHOLS RD STE 401
OSAGE BEACH MO
65065
US

IV. Provider business mailing address

1310 HOMM HILL CT
OSAGE BEACH MO
65065-3537
US

V. Phone/Fax

Practice location:
  • Phone: 573-302-3111
  • Fax: 573-302-2869
Mailing address:
  • Phone: 573-280-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015019127
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number2001014226
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: