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NPI Code Detail

MEDICARE: MRS. THERESA MARIE BORCHERS C.R.N.P.

MEDICARE:  MRS. THERESA MARIE BORCHERS  C.R.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN-191372 NP-05088OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093882243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. THERESA MARIE BORCHERS C.R.N.P.
Provider Business Mailing Address
First Line : 1331 N FAIRFIELD RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2643
Country : US
Telephone Number : 937-426-4280
Fax Number :
Provider Business Practice Location Address
First Line : 1331 N FAIRFIELD RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2643
Country : US
Telephone Number : 937-426-4280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/29/2016

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