Individual
LAURA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1534 E. 15TH ST, EDMOND, OK 73013-3630
(405) 861-0224
Mailing address
1632 CAMDEN WAY # X, EDMOND, OK 73013-2939
(405) 926-0353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
115206
OK
363LF0000X
Family Nurse Practitioner
Primary
200085
OK
Other
Enumeration date
09/10/2020
Last updated
11/08/2022
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