Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 135648 | OK |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 135648 | OK |
NPI | 1063923415 |
---|---|
Provider Name | Mrs. Rachel Cornett Fields |
First Address | Oklahoma City, OK 73107-1818 |
Second Address | Oklahoma City, OK 73112-2098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2017 |
Last Update Date | 14/07/2020 |