F.G.M.A. ,llc.
May also be knows as Family And Geriatric Medical Associates
Family Nurse Practitioner in Oklahoma City, OK(View on Map)
Legal Business Name
F.G.M.A. ,llc.
Also Known As
Family And Geriatric Medical Associates
NPI Number
1922136480
NPI Type
Organization
Enumeration Date
02/28/2007
Specialties
(Taxonomies)Licenses
State
Oklahoma
License Number
R0028064
Contact
Information
Purpose
Mailing
Location
Address
5622 N PORTLAND AVE
5622 N PORTLAND AVE
City
Oklahoma City
Oklahoma City
State
OK
OK
Postal Code
73112-2096
73112-2096
Country
US
US
Telephone Number
(405) 917-7590
(405) 917-7590
Authorized Official
Name
Susan Grandle
Title or Position
NURSE PRACTITIONER
Telephone Number
(405) 917-7590
Identifiers
Identifier
100216830D
R0028064
Identifier State
OK
OK
Identifier Issuer
Unknown
SUSAN GRANDLE LIC #
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/04/2015
Provider Address
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