Provider Demographics
NPI:1811696578
Name:FARAR, RICKIE SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:RICKIE
Middle Name:SUE
Last Name:FARAR
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:3400 NW EXPRESSWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4491
Mailing Address - Country:US
Mailing Address - Phone:405-713-7040
Mailing Address - Fax:405-713-7039
Practice Address - Street 1:3400 NW EXPRESSWAY STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4491
Practice Address - Country:US
Practice Address - Phone:405-713-7040
Practice Address - Fax:405-713-7039
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK0083188163W00000X
OK220607363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse