Individual
DARSHI WICKRAMA EDIRISOORIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1001 N FLORENCE AVE, CLAREMORE, OK 74017-6207
(918) 283-4660
Mailing address
1001 N FLORENCE AVE, CLAREMORE, OK 74017-6207
(918) 283-4660
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
M131211
OK
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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