Healthcare Provider Details

I. General information

NPI: 1619452372
Provider Name (Legal Business Name): VICKI DAWN HAMMONS APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14777 S MEMORIAL DR
BIXBY OK
74008-4372
US

IV. Provider business mailing address

14502 S TOLEDO PL
BIXBY OK
74008-8016
US

V. Phone/Fax

Practice location:
  • Phone: 918-727-2820
  • Fax:
Mailing address:
  • Phone: 918-724-5793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number66643
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number66643
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: