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General NPI Number Information
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NPI Number | 1700800869
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Entity Type | Individual
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Provider Name | THERESA ANNE FLOWERETTE ARNP, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 1230 W MAIN ST STE B
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City | PAWHUSKA
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State | OK
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Zip | 74056-5911
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Country | US
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Telephone | 918-604-5108
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Fax | 918-287-9113
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Provider Business Mailing Address
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Address Line | 1230 W MAIN ST STE B
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City | PAWHUSKA
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State | OK
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Zip | 74056-5911
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Country | US
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Telephone | 918-287-9112
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Fax | 918-287-9113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | R0070154
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 70154
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License Number State | OK
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