Provider Demographics
NPI:1215076781
Name:VELEZ, LAURA LEE (CNS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:VELEZ
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-360-3089
Mailing Address - Fax:405-360-6765
Practice Address - Street 1:3500 HEALTHPLEX PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9738
Practice Address - Country:US
Practice Address - Phone:405-360-3089
Practice Address - Fax:405-360-6765
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0042916364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200237270AMedicaid
OKOKA102099Medicare PIN
OK200237270AMedicaid