Individual
BONNIE DENISE MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
Mailing address
11904 S RANGE RD, PERKINS, OK 74059-4217
(405) 612-7255
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0076759
OK
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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