MEDICARE: VICTORIA DIAZ WELLNESS NP

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
1	374J00000X	Doula	26BDMD	TX
2	363L00000X	Nurse Practitioner	1447976824	OK
3	171400000X	Health & Wellness Coach	1001892	OK
4	101Y00000X	Counselor	CXYG60	OH

General Provider Information

NPI Number	:	1447976824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA DIAZ WELLNESS NP

Provider Business Mailing Address
First Line	:	5909 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-5161
Country	:	US
Telephone Number	:	405-662-0035
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-5161
Country	:	US
Telephone Number	:	405-662-0035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	04/15/2026

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