Provider Demographics
NPI:1679357529
Name:EIMERS-MOSIER, ERIC HARLAN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:HARLAN
Last Name:EIMERS-MOSIER
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:HARLAN
Other - Last Name:EIMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:MEDICINE PARK
Mailing Address - State:OK
Mailing Address - Zip Code:73557-5700
Mailing Address - Country:US
Mailing Address - Phone:580-353-9115
Mailing Address - Fax:405-945-2304
Practice Address - Street 1:2625 GENERAL PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107
Practice Address - Country:US
Practice Address - Phone:405-942-2300
Practice Address - Fax:405-945-2304
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK214707363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health