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General NPI Number Information
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NPI Number | 1194551465
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Entity Type | Individual
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Provider Name | DANIELLE B CORY APRN
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 2308B W HIGHWAY 66
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City | STROUD
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State | OK
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Zip | 74079-6729
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Country | US
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Telephone | 918-968-1642
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Fax | 918-987-1622
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Provider Business Mailing Address
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Address Line | 14201 WIRELESS WAY STE B100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-2521
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Country | US
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Telephone | 405-246-0218
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Fax | 405-594-6089
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0113405
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 220439
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License Number State | OK
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