Healthcare Provider Details

I. General information

NPI: 1730426255
Provider Name (Legal Business Name): LINDA SUZANNE PITCHFORD APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH ST BLDG B SUITE C-60
OKLAHOMA CITY OK
73112-4455
US

IV. Provider business mailing address

3433 NW 56TH ST BLDG B SUITE C-60
OKLAHOMA CITY OK
73112-4455
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3648
  • Fax: 405-951-9785
Mailing address:
  • Phone: 405-949-3648
  • Fax: 405-951-9785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number40144
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: