Healthcare Provider Details

I. General information

NPI: 1952527079
Provider Name (Legal Business Name): APRIL D GENTRY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2556 COVELL VILLAGE DR STE 120
EDMOND OK
73003-9732
US

IV. Provider business mailing address

2556 COVELL VILLAGE DR STE 120
EDMOND OK
73003-9732
US

V. Phone/Fax

Practice location:
  • Phone: 405-978-0700
  • Fax: 405-861-8535
Mailing address:
  • Phone: 405-978-0700
  • Fax: 405-861-8535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN0000108681
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number002416888
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number215257
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: