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NPI Code Detail

MEDICARE: AUDREY NNENNA OBINERO NP-C

MEDICARE: AUDREY NNENNA OBINERO 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
1363LA2200XAdult Health Nurse Practitioner114594OK
2363LP0808XPsychiatric/Mental Health Nurse Practitioner114594OK
3363LA2200XAdult Health Nurse PractitionerF306154-1NY

General Provider Information

NPI Number : 1871935247
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY NNENNA OBINERO NP-C
Provider Business Mailing Address
First Line : 3401 W GORE BLVD
Second Line :
City : LAWTON
State : OK
Zip : 73505-6332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1202 NW ARLINGTON AVE
Second Line :
City : LAWTON
State : OK
Zip : 73507-6537
Country : US
Telephone Number : 580-248-2288
Fax Number : 580-699-3316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2013
Last Update Date : 03/09/2026

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