MEDICARE: BILBY KURIEN

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	363LF0000X	Family Nurse Practitioner	79629	OK

General Provider Information

NPI Number	:	1487105631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILBY KURIEN

Provider Business Mailing Address
First Line	:	8709 NW 105TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-1222
Country	:	US
Telephone Number	:	405-887-7632
Fax Number	:

Provider Business Practice Location Address
First Line	:	8709 NW 105TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-1222
Country	:	US
Telephone Number	:	405-887-7632
Fax Number	:

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

Provider Enumeration Date	:	10/21/2016
Last Update Date	:	10/21/2016

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Directions to “ BILBY KURIEN ” Practice Location

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