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General NPI Number Information
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NPI Number | 1225480510
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Entity Type | Organization
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Legal Business Name | RI-IMAGINE HOLISTIC WOMEN'S HEALTH AND MIDWIFERY CARE PLLC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 2121 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73069-6459
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Country | US
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Telephone | 405-519-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73069-6459
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Country | US
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Telephone | 405-519-5519
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Fax |
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Authorized Official
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Title or Position | CERTIFIED NURSE MIDWIFE
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Name | NETRI TEREF-TA
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Credential | APRN-CNM
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Telephone | 405-519-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number | 0055332
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License Number State | OK
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