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General NPI Number Information
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NPI Number | 1871924969
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Entity Type | Organization
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Legal Business Name | FAR MORE APRN-CNP,PC
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 1101 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3251
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Country | US
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Telephone | 405-341-4643
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Fax | 405-341-6383
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Provider Business Mailing Address
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Address Line | 1101 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3251
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Country | US
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Telephone | 405-341-4643
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Fax | 405-341-6383
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JANICE M MOORE
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Credential | APRN-CNP
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Telephone | 405-341-4643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2013042559
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | R0053173
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License Number State | OK
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