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General NPI Number Information
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NPI Number | 1801396361
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Entity Type | Individual
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Provider Name | LAURIE ANN RAY PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 1932 NW 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-1202
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Country | US
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Telephone | 405-833-1108
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Fax |
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Provider Business Mailing Address
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Address Line | 1932 NW 23RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-1202
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Country | US
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Telephone | 405-833-1108
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Fax | 405-673-7325
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7352
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2871
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License Number State | OK
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