Individual
TAYLOR LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
2703 N 14TH ST, PONCA CITY, OK 74601-1738
(580) 765-9451
Mailing address
2703 N 14TH ST, PONCA CITY, OK 74601-1738
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
112042
OK
363LF0000X
Family Nurse Practitioner
Primary
R0112042
OK
Other
Enumeration date
12/26/2018
Last updated
05/13/2024
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