Organization
PALLIATIVE CARE PROCEDURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRIANNA SPARKS APRN (OWNER/PROVIDER)
(405) 659-5525
Entity
Organization
Contact information
Practice address
1604 SW 38TH ST, MOORE, OK 73160-2953
(405) 659-5525
(800) 396-6706
Mailing address
1604 SW 38TH ST, MOORE, OK 73160-2953
(405) 659-5525
(800) 396-6706
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/26/2021
Last updated
05/14/2021
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