Bourne, Michelle L

Bourne, Michelle L is an individual health care provider with primary practice located at 2080 Hwy 9 West , Norman OK 73072. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bourne, Michelle L can be contacted via phone (405) 322-6800.

Contact Information

Primary practice address
2080 Hwy 9 West Norman OK 73072
Phone: (405) 322-6800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1164 Oklahoma

Profile Details

NPI number 1124027263
LBN Legal business name Bourne, Michelle L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Feb 12th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124027263 NPPES
Oklahoma MEDICAID 100138520A

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