Healthcare Provider Details

I. General information

NPI: 1225673122
Provider Name (Legal Business Name): HANNAH R GOODSPEED APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH SAWATZKY

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 W 33RD ST
EDMOND OK
73013-3831
US

IV. Provider business mailing address

1745 W 33RD ST
EDMOND OK
73013-3831
US

V. Phone/Fax

Practice location:
  • Phone: 405-665-7993
  • Fax:
Mailing address:
  • Phone: 405-665-7993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114328
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number114328
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: