Healthcare Provider Details

I. General information

NPI: 1184779167
Provider Name (Legal Business Name): SUSAN LYNN WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E MAIN ST 52-200
NORMAN OK
73071-5305
US

IV. Provider business mailing address

1204 E BROOKS ST
NORMAN OK
73071-2515
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-6464
  • Fax:
Mailing address:
  • Phone: 405-447-4370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR0079253
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: