Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | OK | |
Y | 176B00000X | Midwife | 200172 | OK |
N | 363L00000X | Nurse Practitioner | 200172 | OK |
NPI | 1013509728 |
---|---|
Provider Name | Laura Coleen Byous |
First Address | Durant, OK 74701-4911 |
Second Address | Ada, OK 74820-3439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2021 |
Last Update Date | 04/02/2021 |