Individual
BETTINA VERONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 N SANTA FE AVE, EDMOND, OK 73003-3638
(405) 285-0660
(405) 285-0659
Mailing address
4401 W MEMORIAL RD, SUITE 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17563
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17563
LICENSE
OK
05
—
200059560A
—
OK
01
—
22871
OBNDD
OK
Enumeration date
05/05/2006
Last updated
05/21/2014
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