Provider Demographics
NPI:1962601450
Name:WIER, MARY T (WOMENS HEALTHCARE NP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:T
Last Name:WIER
Suffix:
Gender:F
Credentials:WOMENS HEALTHCARE NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-2098
Mailing Address - Country:US
Mailing Address - Phone:405-235-6466
Mailing Address - Fax:405-235-0826
Practice Address - Street 1:420 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-2805
Practice Address - Country:US
Practice Address - Phone:405-235-6466
Practice Address - Fax:405-235-0826
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0037693363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health