Provider Demographics
NPI:1790735371
Name:LORIMOR, MARGARET A (FNP C RN MSN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:LORIMOR
Suffix:
Gender:F
Credentials:FNP C RN MSN
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:RAVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP C RN MSN
Mailing Address - Street 1:3077 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044
Mailing Address - Country:US
Mailing Address - Phone:405-282-3898
Mailing Address - Fax:405-260-0429
Practice Address - Street 1:3077 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044
Practice Address - Country:US
Practice Address - Phone:405-282-3898
Practice Address - Fax:405-260-0429
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN087532363LF0000X
OKR0084764364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP33273Medicare UPIN
OK65882Medicare PIN