Healthcare Provider Details

I. General information

NPI: 1154861276
Provider Name (Legal Business Name): LAURIE FERRER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 S YALE AVE STE B
TULSA OK
74135-6002
US

IV. Provider business mailing address

4103 S YALE AVE STE B
TULSA OK
74135-6002
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-7300
  • Fax: 918-382-7302
Mailing address:
  • Phone: 918-382-7300
  • Fax: 918-382-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017002508
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0134145
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: