Healthcare Provider Details

I. General information

NPI: 1013899210
Provider Name (Legal Business Name): MICAH DAWN MAJORS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICAH DAWN GOAD

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 LARIAT ST
EL RENO OK
73036-3674
US

IV. Provider business mailing address

275 LARIAT ST
EL RENO OK
73036-3674
US

V. Phone/Fax

Practice location:
  • Phone: 405-623-5019
  • Fax:
Mailing address:
  • Phone: 405-623-5019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR0113337
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: