MEDICARE: MARY CATHRYN MERIDETH ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R0077161	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114930229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CATHRYN MERIDETH ARNP

Provider Business Mailing Address
First Line	:	530 N MONTE VISTA
Second Line	:	SUITE A
City	:	ADA
State	:	OK
Zip	:	74820-4675
Country	:	US
Telephone Number	:	580-436-7101
Fax Number	:	580-436-4447

Provider Business Practice Location Address
First Line	:	2017 W I 35 FRONTAGE RD
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-8504
Country	:	US
Telephone Number	:	405-509-2800
Fax Number	:	405-509-2885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	12/01/2014

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Directions to “ MARY CATHRYN MERIDETH ARNP” Practice Location

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