Individual
TAYLOR BONSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
900 E MAIN ST, NORMAN, OK 73071-5305
(405) 307-4800
Mailing address
4009 MADISON AVE, MOORE, OK 73160-7649
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
126682
OK
163WP0808X
Psychiatric/Mental Health Registered Nurse
126682
OK
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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