Healthcare Provider Details

I. General information

NPI: 1013841956
Provider Name (Legal Business Name): LAUREN RAE WHEELER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN RAE LUGAFET

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 W I 35 FRONTAGE RD STE 140
EDMOND OK
73013-8555
US

IV. Provider business mailing address

613 E CLEVELAND AVE
GUTHRIE OK
73044-3403
US

V. Phone/Fax

Practice location:
  • Phone: 405-757-3710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5907
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: