Organization
WILLOW MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA MOORMAN APRN, FNP-C (APRN, FNP-C)
(539) 208-5069
Entity
Organization
Contact information
Practice address
12806 E 86TH PL N STE A, OWASSO, OK 74055-2688
(539) 208-5069
(539) 208-5440
Mailing address
12806 E 86TH PL N STE A, OWASSO, OK 74055-2688
(539) 208-5069
(539) 208-5440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
03/13/2024
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