Healthcare Provider Details

I. General information

NPI: 1649684531
Provider Name (Legal Business Name): SARAH FLORA APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 36TH AVE NW STE 100
NORMAN OK
73072-4104
US

IV. Provider business mailing address

1139 36TH AVE NW STE 100
NORMAN OK
73072-4104
US

V. Phone/Fax

Practice location:
  • Phone: 405-217-9997
  • Fax: 405-307-8520
Mailing address:
  • Phone: 405-217-9997
  • Fax: 405-307-8520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number73216
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: