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General NPI Number Information
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NPI Number | 1790285849
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Entity Type | Organization
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Legal Business Name | MM HEALTH APRN-CNP PLLC
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 200 N BRYANT AVE STE 120
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City | EDMOND
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State | OK
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Zip | 73034-6273
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Country | US
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Telephone | 405-832-6881
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Fax | 833-941-1685
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Provider Business Mailing Address
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Address Line | 200 N BRYANT AVE STE 120
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City | EDMOND
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State | OK
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Zip | 73034-6273
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Country | US
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Telephone | 405-832-6881
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Fax | 833-941-1685
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | MELISA WEAVER
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Credential | APRN-CNP
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Telephone | 405-844-3317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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