Individual
LORI ANN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4502 E 41ST ST RM 1C76, TULSA, OK 74135-2536
(918) 660-3102
(918) 660-3101
Mailing address
4502 E 41ST ST RM 1C76, TULSA, OK 74135-2536
(918) 660-3102
(918) 660-3101
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
79283
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200502080A
—
OK
Enumeration date
07/29/2013
Last updated
02/24/2023
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