| Doctor Name: | LORA MAY VAVERKA |
| NPI Number: | 1124036744 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | R0051279 |
| Business Practice Address: | 500 N Main St Hennessey, OK - 737421019 |
| Business Phone Number: | 4058536100 |
| Business Fax Number: | 4058534491 |
| Mailing Address: | Po Box 844737, DALLAS |
| State: | TX |
| Postal Code: | 752844737 |
| Phone Number: | 4405853610 |
| Fax Number: | 4058534491 |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 07/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R0051279 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |