Provider Demographics
NPI:1104978360
Name:CORDEIRO, MARIA DARLENE (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DARLENE
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 OLDE NORTH PL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4942
Mailing Address - Country:US
Mailing Address - Phone:405-513-6466
Mailing Address - Fax:
Practice Address - Street 1:10017 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6919
Practice Address - Country:US
Practice Address - Phone:405-759-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN050601363LG0600X
OK53063363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology