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NPI Code Detail

MEDICARE: MRS. REGINA GEORGE APRN-CNP

MEDICARE: MRS. REGINA GEORGE APRN-CNP
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
1363LA2200XAdult Health Nurse Practitioner104916OK

General Provider Information

NPI Number : 1609110931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REGINA GEORGE APRN-CNP
Provider Business Mailing Address
First Line : 10413 GREENBRIAR PKWY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-7656
Country : US
Telephone Number : 405-691-4665
Fax Number : 405-378-7628
Provider Business Practice Location Address
First Line : 10413 GREENBRIAR PKWY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-7656
Country : US
Telephone Number : 405-691-4665
Fax Number : 405-378-7628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2012
Last Update Date : 11/11/2013

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