Basic Information
Provider Information
NPI: 1619314481
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORMS
FirstName: CYNTHIA
MiddleName: JOAN
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ADAMS
OtherFirstName: CYNTHIA
OtherMiddleName: JOAN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 650 S PEORIA AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741204429
CountryCode: US
TelephoneNumber: 9185879471
FaxNumber:  
Practice Location
Address1: 650 S PEORIA AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741204429
CountryCode: US
TelephoneNumber: 9185879471
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2013
LastUpdateDate: 06/03/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X0076774OKY AgenciesCommunity/Behavioral Health 

No ID Information.


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