Individual
MRS. MARY FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
Mailing address
2908 NW 19TH ST, OKLAHOMA CITY, OK 73107-3911
(405) 250-6080
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
82870
OK
Other
Enumeration date
05/28/2016
Last updated
02/04/2019
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