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Individual

TERESA LYNN TOOMBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 453-2148
Mailing address
PO BOX 579, PARK HILL, OK 74451-0579
(918) 772-0990

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704279215
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
572751
TX
367500000X
Certified Registered Nurse Anesthetist
93952
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154341701
AR
05
166116701
TX
05
166116702
TX
05
1770581001
MI
01
4308712170
BCBS
MI
01
82710
BLUE CROSS
AR
01
83898U
BLUE CROSS
TX
01
88460U
BCBS
TX
Enumeration date
07/11/2005
Last updated
02/27/2018
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