Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Douglas Mukorombindo

Individual provider Family Nurse Practitioner · NPI 1326764127

Douglas Mukorombindo is a Nurse Practitioner in Edmond, Oklahoma. Qualified in 2021, 5 years ago. Works from 2 locations. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2022
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5400 E Memorial Rd
Edmond, OK 73013-8213
Phone: (405) 459-7016
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 247 Moncrief Dr, Valparaiso, IN 46385-7752 — (317) 459-5146

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 28214779A (IN)

Record details

NPI number1326764127
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2022
Last updated in NPPESOctober 13, 2022
Certification dateOctober 13, 2022
Mailing address5400 E Memorial Rd, Edmond, OK 73013-8213

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Edmond