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General NPI Number Information
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NPI Number | 1588479828
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Entity Type | Organization
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Legal Business Name | CENTRAL OKLAHOMA DIABETES CENTER, PLLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 2429 WESTPORT DR
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City | NORMAN
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State | OK
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Zip | 73069-6337
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Country | US
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Telephone | 405-801-4050
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Fax | 405-561-4978
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Provider Business Mailing Address
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Address Line | 1912 HALLBROOKE DR
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City | NORMAN
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State | OK
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Zip | 73071-3910
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Country | US
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Telephone | 405-412-8456
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Fax | 405-561-4978
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | ANGELA MICHELLE DORNEY
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Credential | APRN-CNP
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Telephone | 405-801-4050
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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 |
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License Number State |
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