Healthcare Provider Details

I. General information

NPI: 1811408701
Provider Name (Legal Business Name): DORIS CHINYERE OFFIAH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 2ND STREET
WELLSTON OK
74881-0009
US

IV. Provider business mailing address

PO BOX 9
WELLSTON OK
74881-0009
US

V. Phone/Fax

Practice location:
  • Phone: 405-232-0101
  • Fax: 405-232-0102
Mailing address:
  • Phone: 405-232-0101
  • Fax: 405-232-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0089933
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: