Provider Demographics
NPI:1316047442
Name:STURM, TERESA BARKER (RPT)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:BARKER
Last Name:STURM
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:TERESA
Other - Last Name:STURM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:2828 ROAD L
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-7906
Mailing Address - Country:US
Mailing Address - Phone:785-528-1123
Mailing Address - Fax:
Practice Address - Street 1:104 WEST MARKET
Practice Address - Street 2:SUITE B
Practice Address - City:OSAGE CITY
Practice Address - State:KS
Practice Address - Zip Code:66523
Practice Address - Country:US
Practice Address - Phone:785-528-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1100251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP33865Medicare UPIN
KS140067Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER