Healthcare Provider Details

I. General information

NPI: 1649990722
Provider Name (Legal Business Name): MEAGAN KAY MEFFERT APRN-CNP-,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 N.HWY 66 STE B
CATOOSA OK
74015
US

IV. Provider business mailing address

1213 CANTON ST
BROKEN ARROW OK
74012
US

V. Phone/Fax

Practice location:
  • Phone: 918-419-0860
  • Fax:
Mailing address:
  • Phone: 918-787-1584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number208378
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: