Provider Demographics
NPI:1871211771
Name:BYRNS-DONAHOO, TERRI
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:BYRNS-DONAHOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 PRUITT DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5647
Mailing Address - Country:US
Mailing Address - Phone:405-808-4662
Mailing Address - Fax:
Practice Address - Street 1:1061 PRUITT DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5647
Practice Address - Country:US
Practice Address - Phone:405-808-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKUNKNOWNOtherUNKNOWN