Healthcare Provider Details

I. General information

NPI: 1447168133
Provider Name (Legal Business Name): RAYA ARREDONDO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15301 CROWN AT LONE OAK RD
EDMOND OK
73013-2273
US

IV. Provider business mailing address

936 BROWN DR
MIDWEST CITY OK
73110-2580
US

V. Phone/Fax

Practice location:
  • Phone: 405-999-4253
  • Fax:
Mailing address:
  • Phone: 580-713-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number213833
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: