Individual
TERESA D FORMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
520 CHAUTAUQUA BLVD, VALLEY CITY, ND 58072-3145
(701) 845-6000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R23725
ND
Other
Enumeration date
08/10/2020
Last updated
05/21/2024
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