Healthcare Provider Details

I. General information

NPI: 1487738514
Provider Name (Legal Business Name): CYNTHIA LOUISE MILLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHWEST PEDIATRICS, PLLC 937 S.W. 89, SUITE A
OKLAHOMA CITY OK
73139
US

IV. Provider business mailing address

4116 BENTBROOK PL
NORMAN OK
73072-4021
US

V. Phone/Fax

Practice location:
  • Phone: 405-631-2379
  • Fax: 405-631-3377
Mailing address:
  • Phone: 405-292-5953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR0075050
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: