institution
F.g.m.a. ,llc.
Family Nurse Practitioner in Oklahoma City, Oklahoma
NPI 1922136480

F.g.m.a. ,llc. is a Family Nurse Practitioner based in Oklahoma City, OK and is specialized in Family. F.g.m.a. ,llc. practices in Oklahoma City, OK. The NPI Number for F.g.m.a. ,llc. is 1922136480 and holds a License No. R0028064 (Oklahoma).

The current practice location address for F.g.m.a. ,llc. is 5622 N Portland Ave, Oklahoma City, OK and can be reached out via phone at 405-917-7590 and via fax at 405-917-7595.

Location: 5622 N Portland Ave, Oklahoma City, OK, 73112-2096
institution
Provider Profile Details
NPI Number
1922136480
Provider Name
F.g.m.a. ,llc.
Credential
Provider Entity Type
Organization
Address
5622 N Portland Ave, Oklahoma City, OK, 73112-2096
Phone Number
405-917-7590
Fax Number
405-917-7595
Provider Enumeration Date
02/28/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100216830D 05 OK
R0028064 01 OK SUSAN GRANDLE LIC #
institution
Provider Business Practice Location Address Details
Address
5622 N Portland Ave
City
State
Zip
73112-2096
Phone Number
405-917-7590
Fax Number
405-917-7595
person
Provider Business Mailing Address Details
Address
5622 N Portland Ave
City
State
Zip
73112-2096
Phone Number
405-917-7590
Fax Number
405-917-7595
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R0028064 (Oklahoma)
Definition
Definition to come...
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