Provider Demographics
NPI:1952418774
Name:PURSLEY, FREDETTE LENORA (NP)
Entity Type:Individual
Prefix:MRS
First Name:FREDETTE
Middle Name:LENORA
Last Name:PURSLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:FREDETTE
Other - Middle Name:LENORA
Other - Last Name:PURSLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:618 S FLOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4553
Mailing Address - Country:US
Mailing Address - Phone:405-366-7654
Mailing Address - Fax:
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-270-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKROO56036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily