Central Oklahoma Diabetes Center Aprn CNP NP-C PLLC

Organization Active NPI Nurse Practitioner · Norman, OK

NPI 1073990602 · NPPES record last updated Jun 7, 2016

Key facts

NPI
1073990602
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
License
76737 (OK)
Legal business name
CENTRAL OKLAHOMA DIABETES CENTER APRN CNP NP-C PLLC
Practice address
1010 24TH Ave NW
Suite 110
Norman, OK 73069-6494
Phone
(405) 801-4050
Fax
(405) 701-8988
NPI assigned
May 4, 2015
Organization subpart
No

Authorized official

Name
Leah Dawn Melton, APRN, CNP NPI 1679824601
Title
Owner
Phone
(405) 546-0468

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160919001983 OK Part B Supplier - Clinic/Group Practice 2264729268 Receives reassigned benefits from 1 practitioner
Practice locations: Norman, OK

National Provider Directory

Locations

800 Wall St
Norman, OK 73069
Phone (405) 329-3500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X 76737 OK Yes

Addresses

Primary practice location

1010 24TH Ave NW
Suite 110
Norman, OK 73069-6494

Mailing address

1010 24TH Ave NW
Suite 110
Norman, OK 73069-6494
Phone (405) 801-4050

Other providers in Norman, OK

All providers in Norman, OK · Nurse Practitioner in Oklahoma

Sources for this page

Verify at the official NPI Registry.