Individual
MR. STORM MICHAEL EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
303 SE 4TH ST, MOORE, OK 73160-6709
(405) 515-0530
(405) 307-5651
Mailing address
PO BOX 1330, NORMAN, OK 73070
(405) 307-6668
(405) 701-6170
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
72469
OK
Other
Enumeration date
09/26/2013
Last updated
06/30/2021
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