Provider Demographics
NPI:1780787937
Name:BUOL, TERESA R (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:BUOL
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:R
Other - Last Name:SEXE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:1310 HOMM HILL CT
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3537
Mailing Address - Country:US
Mailing Address - Phone:573-280-8382
Mailing Address - Fax:
Practice Address - Street 1:1029 NICHOLS RD STE 401
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065
Practice Address - Country:US
Practice Address - Phone:573-302-3111
Practice Address - Fax:573-302-2869
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015019127363LF0000X
MO2001014226163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
RNFAOtherRN FIRST ASSISTANT
050032OtherCNOR
RNFAOtherRN FIRST ASSISTANT