Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 86336 | OK |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R0086336 | OK |
NPI | 1023433901 |
---|---|
Provider Name | Rhonda Mose |
First Address | Edmond, OK 73012-2803 |
Second Address | Oklahoma City, OK 73108-1839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2014 |
Last Update Date | 23/06/2021 |