MEDICARE: JOHN M LAYMON APRN

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	363LA2200X	Adult Health Nurse Practitioner	92354	OK

General Provider Information

NPI Number	:	1528355674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M LAYMON APRN

Provider Business Mailing Address
First Line	:	17026 E 47TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-7231
Country	:	US
Telephone Number	:	918-645-6315
Fax Number	:	918-300-4954

Provider Business Practice Location Address
First Line	:	17026 E 47TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74134-7231
Country	:	US
Telephone Number	:	918-645-6315
Fax Number	:	918-300-4954

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

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	10/16/2023

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