Healthcare Provider Details

I. General information

NPI: 1790735371
Provider Name (Legal Business Name): MARGARET A. LORIMOR FNP C RN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET A. RAVEN FNP C RN MSN

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3077 E COLLEGE AVE
GUTHRIE OK
73044
US

IV. Provider business mailing address

3077 E COLLEGE AVE
GUTHRIE OK
73044
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-3898
  • Fax: 405-260-0429
Mailing address:
  • Phone: 405-282-3898
  • Fax: 405-260-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN087532
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberR0084764
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: