Provider Demographics
NPI:1700490489
Name:OURADA, TERI JEAN (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:TERI
Middle Name:JEAN
Last Name:OURADA
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MCCOLLUM ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-5151
Mailing Address - Country:US
Mailing Address - Phone:307-745-0085
Mailing Address - Fax:
Practice Address - Street 1:204 MCCOLLUM ST STE 104
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-5151
Practice Address - Country:US
Practice Address - Phone:307-745-0085
Practice Address - Fax:307-745-0084
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY48446363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily