Provider Demographics
NPI:1083633291
Name:MAYFIELD, VICKI LYNN (LMET RN)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LYNN
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LMET RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 N W 72ND
Mailing Address - Street 2:S 310
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132
Mailing Address - Country:US
Mailing Address - Phone:405-620-4597
Mailing Address - Fax:405-773-4349
Practice Address - Street 1:5601 N W 72ND
Practice Address - Street 2:S 310
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73132
Practice Address - Country:US
Practice Address - Phone:405-620-4597
Practice Address - Fax:405-773-4349
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK286106H00000X
OKR0028140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse