Individual
DR. MORIAM BOLARE NA-ALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2712 GREENFIELD DR, EDMOND, OK 73012-6531
(405) 923-0952
Mailing address
2712 GREENFIELD DR, EDMOND, OK 73012-6531
(405) 923-0952
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
111165
OK
363LP2300X
Primary Care Nurse Practitioner
111165
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111165
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
09/04/2019
Last updated
12/09/2023
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