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Individual

TERESA MELINDA JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN CFNP

Contact information

Practice address
1317 S DEWEY AVE, WAGONER, OK 74467-7013
(918) 401-1002
Mailing address
PO BOX 348, BRAGGS, OK 74423-0348
(918) 351-3431

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
99271
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200901640A
OK
01
99271
OKLAHOMA BON
OK
Enumeration date
02/04/2020
Last updated
02/21/2024
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