Provider Demographics
NPI:1699326678
Name:VON OESEN, TERRI LYNN (RN)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:VON OESEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MOOSEHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:DIXMONT
Mailing Address - State:ME
Mailing Address - Zip Code:04932-3021
Mailing Address - Country:US
Mailing Address - Phone:207-217-1184
Mailing Address - Fax:
Practice Address - Street 1:235 MOOSEHEAD TRL
Practice Address - Street 2:
Practice Address - City:DIXMONT
Practice Address - State:ME
Practice Address - Zip Code:04932-3021
Practice Address - Country:US
Practice Address - Phone:207-217-1184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN57807163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse