Individual ProviderTeresa ShiversCase Manager/Care CoordinatorOther Service ProvidersPractice Address1605 N Harrison St, Shawnee, OK 74804-4022(405) 481-7187(405) 590-8584PECOS EnrollmentBased on the most recent information from CMS, provider Teresa Shivers does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1225434251Provider TypeIndividualFull NameShivers, TeresaCredentialMASTERS EDGenderFemaleSole ProprietorYesEnumeration Date11/19/2014Last Updated11/19/2014Contact InformationPractice LocationPractice Address1605 N Harrison St, Shawnee, OK 74804-4022Phone(405) 481-7187FaxUnlisted FaxMailing LocationMailing Address48595 Wolverine Rd, Prague, OK 74864-1250Phone(405) 590-8584FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerOklahoma