Healthcare Provider Details

I. General information

NPI: 1942726930
Provider Name (Legal Business Name): STARLA RANEE HARRIS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 W IOWA AVE
CHICKASHA OK
73018-2738
US

IV. Provider business mailing address

250 12TH AVE NE
NORMAN OK
73071-5237
US

V. Phone/Fax

Practice location:
  • Phone: 405-224-8111
  • Fax:
Mailing address:
  • Phone: 405-321-4048
  • Fax: 405-364-6761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71474
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71474
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: