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Individual

SUSAN L QUISENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1211 N SHARTEL AVE, SUITE 700, OKLAHOMA CITY, OK 73103-2400
(405) 702-6700
Mailing address
PO BOX 5722, NORMAN, OK 73070-5722
(405) 702-6700

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
705243
TX
363L00000X
Nurse Practitioner
Primary
R0059860
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200085250A
OK
Enumeration date
06/12/2006
Last updated
09/29/2011
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