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Nursing Service Providers Registered Nurse Psychiatric/Mental Health

Provider NPI: 1790272045

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 405-858-2700  Fax: --

Business Mailing Address:
PO BOX 12978  OKLAHOMA CITY, OK 73157-2978 US
Tel: --  Fax: --

NPI Information:
NPI: 1790272045
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y163WP0808XNursing Service Providers
Registered Nurse
Psychiatric/Mental Health

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 163WP0808X





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