Healthcare Provider Details

I. General information

NPI: 1730090382
Provider Name (Legal Business Name): LEXIE BEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N BROADWAY ST
INOLA OK
74036-9419
US

IV. Provider business mailing address

PO BOX 1149
INOLA OK
74036-1149
US

V. Phone/Fax

Practice location:
  • Phone: 918-543-0500
  • Fax: 918-543-8754
Mailing address:
  • Phone: 918-543-0500
  • Fax: 918-543-8754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0106463
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: