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NPI Code Detail

MEDICARE: MELISSA SUE ALFRED

MEDICARE:   MELISSA SUE ALFRED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP9332497FL
2363LF0000XFamily Nurse Practitioner122605OK

General Provider Information

NPI Number : 1295193910
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA SUE ALFRED
Provider Business Mailing Address
First Line : 3000 N GRAND BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-1818
Country : US
Telephone Number : 405-632-6688
Fax Number :
Provider Business Practice Location Address
First Line : 2400 NW 36TH ST STE 100
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7844
Country : US
Telephone Number : 405-326-6688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2016
Last Update Date : 05/14/2024

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Directions to “ MELISSA SUE ALFRED ” Practice Location

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