Individual
JEREMY MOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1123 S PITTSBURG AVE, TULSA, OK 74112-5103
(918) 516-8114
Mailing address
1123 S PITTSBURG AVE, TULSA, OK 74112-5103
(918) 516-8114
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200600
OK
Other
Enumeration date
12/10/2021
Last updated
06/28/2022
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