Individual
TERA OSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC-OB, IBCLC, BSN
Contact information
Practice address
204 NW 152ND ST, EDMOND, OK 73013-2127
(918) 853-1072
Mailing address
4801 INTEGRIS PKWY, EDMOND, OK 73034-8864
(918) 853-1072
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-318707
OK
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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