Individual provider · Type 1 NPI

Mary Grace Difuntorum, APRN, FNP

Family Nurse Practitioner · Moore, OK

NPI number 1659078129 Active

Practice location

400 N Eastern Ave
Moore, OK 73160-5833

Fax (405) 730-6992

Mailing address

PO Box 891625
Oklahoma City, OK 73189-1625

Other practice locations

  • 160 E SW 59th St, Mustang, OK 73064-4722 · (405) 730-6990

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X210920 (OK)

Family Nurse Practitioner: Definition to come...

26 other providers at this address

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About NPI 1659078129

Mary Grace Difuntorum, APRN, FNP's National Provider Identifier is 1659078129, issued on Feb 14, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Moore, OK. The record was last updated on Jul 4, 2026.