MEDICARE: MRS. CIBY DANIEL JOSEPH APRN,NP-C

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	363LF0000X	Family Nurse Practitioner	0084510	OK

General Provider Information

NPI Number	:	1598191959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CIBY DANIEL JOSEPH APRN,NP-C

Provider Business Mailing Address
First Line	:	7324,SANDLEWOOD DRIVE
Second Line	:
City	:	OKLAHOMA
State	:	OK
Zip	:	73132
Country	:	US
Telephone Number	:	405-603-8538
Fax Number	:

Provider Business Practice Location Address
First Line	:	3366 NW EXPRESSWAY STE 660
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4416
Country	:	US
Telephone Number	:	405-947-3345
Fax Number	:	405-945-0242

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	01/28/2020

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