Provider Demographics
NPI:1700642022
Name:MEREQ CONSULTANT LLC
Entity Type:Organization
Organization Name:MEREQ CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:QUEEN
Authorized Official - Middle Name:OYOMERE
Authorized Official - Last Name:ERUE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:918-815-7671
Mailing Address - Street 1:21571 E 40TH PL S
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8776
Mailing Address - Country:US
Mailing Address - Phone:918-815-7671
Mailing Address - Fax:
Practice Address - Street 1:8803 S 101ST EAST AVE STE 350
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5772
Practice Address - Country:US
Practice Address - Phone:918-615-3750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty