Individual
MRS. LAURIE NICOLE TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3330 NW 56TH ST STE 206, OKLAHOMA CITY, OK 73112-4426
(405) 945-4710
(405) 562-9242
Mailing address
3330 NW 56TH ST, STE 206, OKLAHOMA CITY, OK 73112-4426
(405) 945-4710
(405) 562-9242
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2016
OK
363A00000X
Physician Assistant
MA056098
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200333010A
—
OK
Enumeration date
05/09/2011
Last updated
03/17/2018
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