Healthcare Provider Details

I. General information

NPI: 1033686845
Provider Name (Legal Business Name): CATHY LYNN DALRYMPLE APRN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 6TH ST
RYAN OK
73565-9549
US

IV. Provider business mailing address

2210 DUNCAN REGIONAL LOOP
DUNCAN OK
73533-1564
US

V. Phone/Fax

Practice location:
  • Phone: 580-757-2451
  • Fax: 580-757-2415
Mailing address:
  • Phone: 956-873-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number58851
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: