Provider Demographics
NPI:1952502031
Name:WINCHESTER, LORA REBECCA (APRN, BC)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:REBECCA
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S DOUGLAS BLVD STE K
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5263
Mailing Address - Country:US
Mailing Address - Phone:405-737-4900
Mailing Address - Fax:
Practice Address - Street 1:1201 S DOUGLAS BLVD STE K
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5263
Practice Address - Country:US
Practice Address - Phone:405-737-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2007003118364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health