FORMAN, TAYLOR BREANN - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

FORMAN, TAYLOR BREANN

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	THREE RIVERS HEALTH CENTER 1001 S 41ST ST E MUSKOGEE OK 74403 Address last updated on 10/2/2024
Phone #:	(918) 978-3061
Fax #:
County:	MUSKOGEE
License:	5976
Dated:	5/28/2021
Expires:	1/31/2025
License Type:	Physical Therapist
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
THREE RIVERS HEALTH CENTER 1001 S 41ST ST E MUSKOGEE OK 74403 Phone #: (918) 978-3061 Fax #:

Name:	Type:	License Number:
Primary Supervisees(s):
NICOLE OLIVIA ARNEY	TA	3204
JARRETT CARLTON BAILEY	TA	1222
AMY DAWN BURKHART	TA	1658
AMY DAWN BURKHART	TA	1658
MICHAEL DAVIS	TA	2057
KAYLEE NICOLE DELATORRE	TA	2991
RAGAN WILSON DOWNEY	TA	3077
EMILEE NICOLE GRAVES	TA	3518
DAVID RAYMOND JORDAN	TA	3060
BAYLEI LAINE RICHARDSON	TA	3729
TAYLOR RAYLYNN SCOTT	TA	3761
DENISE JOELLEN SELLERS	TA	1363
TIFFANY NICHOLE THOMPSON	TA	3213
DALTON TY WHITEBIRD	TA	3033

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