Healthcare Provider Details

I. General information

NPI: 1558856435
Provider Name (Legal Business Name): COURTNEY DAHI DNP, APRN-CNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W IOWA AVE
CHICKASHA OK
73018
US

IV. Provider business mailing address

2222 W IOWA AVE
CHICKASHA OK
73018-2738
US

V. Phone/Fax

Practice location:
  • Phone: 405-224-8111
  • Fax: 405-222-9557
Mailing address:
  • Phone: 405-224-8111
  • Fax: 405-222-9557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number109395
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: