Provider Demographics
NPI:1356171979
Name:VIESCA BORUNDA, DANIA (RN)
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:
Last Name:VIESCA BORUNDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DANIA
Other - Middle Name:
Other - Last Name:BORUNDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1201 N EUNICE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-4050
Mailing Address - Country:US
Mailing Address - Phone:405-476-0007
Mailing Address - Fax:
Practice Address - Street 1:800 NE 10TH ST # 2100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5418
Practice Address - Country:US
Practice Address - Phone:405-271-8707
Practice Address - Fax:405-271-2976
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0087245163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care