Provider Demographics
NPI:1326510488
Name:DEFFIT, DORI LYNN (APRN CNP)
Entity Type:Individual
Prefix:MS
First Name:DORI
Middle Name:LYNN
Last Name:DEFFIT
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 S SCRAPER ST STE D
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-3740
Mailing Address - Country:US
Mailing Address - Phone:918-276-2667
Mailing Address - Fax:918-276-2666
Practice Address - Street 1:244 S SCRAPER ST
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-3740
Practice Address - Country:US
Practice Address - Phone:918-276-2667
Practice Address - Fax:918-276-2666
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK105307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily