Healthcare Provider Details

I. General information

NPI: 1043856230
Provider Name (Legal Business Name): LORI K SCOTT, APRN-CNP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 N MACARTHUR BLVD # 280
OKLAHOMA CITY OK
73162-1800
US

IV. Provider business mailing address

12101 N MACARTHUR BLVD # 280
OKLAHOMA CITY OK
73162-1800
US

V. Phone/Fax

Practice location:
  • Phone: 405-328-4380
  • Fax:
Mailing address:
  • Phone: 405-328-4380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI SCOTT
Title or Position: OWNER
Credential: APRN-CNP
Phone: 405-328-4380