Healthcare Provider Details

I. General information

NPI: 1134926744
Provider Name (Legal Business Name): MARIA ANGELES NIETO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA ANGELES FLORES RN

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

5406 NICOLE DR
TUTTLE OK
73089-0048
US

V. Phone/Fax

Practice location:
  • Phone: 325-338-3202
  • Fax:
Mailing address:
  • Phone: 325-338-3202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberR0112106
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: