MEDICARE: DOROTHY CLEVELAND POINTER CNM

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	171400000X	Health & Wellness Coach
2	367A00000X	Advanced Practice Midwife	80040	OK

General Provider Information

NPI Number	:	1306072285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY CLEVELAND POINTER CNM

Provider Business Mailing Address
First Line	:	9208 SW 24TH ST STE 408
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73128-4902
Country	:	US
Telephone Number	:	405-410-7311
Fax Number	:	405-745-7455

Provider Business Practice Location Address
First Line	:	9208 SW 24TH ST STE 408
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73128-4902
Country	:	US
Telephone Number	:	405-410-7311
Fax Number	:	405-745-7455

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	03/23/2023

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