Provider Demographics
NPI:1952404832
Name:WEBBER, DIANA MORGAN (ARNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MORGAN
Last Name:WEBBER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:ADAMS
Other - Last Name:WEBBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:LANE
Mailing Address - State:OK
Mailing Address - Zip Code:74555-0236
Mailing Address - Country:US
Mailing Address - Phone:580-889-7163
Mailing Address - Fax:
Practice Address - Street 1:420 SW 10TH ST
Practice Address - Street 2:OU PEDIATRIC LATINO CLINIC
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-5610
Practice Address - Country:US
Practice Address - Phone:405-271-6615
Practice Address - Fax:405-271-6614
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0051062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily