Individual
DR. AJEMINAYANATE IMINABO BEREPELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
2032 BUENA VIDA LN, EDMOND, OK 73013-2184
(405) 537-3787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
205166
OK
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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