Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 86131 | OK |
NPI | 1013392737 |
---|---|
Provider Name | Debra O'day |
First Address | Stillwater, OK 74074-4306 |
Second Address | Stillwater, OK 74074-4306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2015 |
Last Update Date | 23/07/2015 |