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Individual

MARISHA DAWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Mailing address
1416 NW 105TH ST, OKLAHOMA CITY, OK 73114-5116

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0088014
OK
363L00000X
Nurse Practitioner
214871
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
214871
OK

Other

Enumeration date
07/07/2023
Last updated
12/04/2023
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