Healthcare Provider Details
I. General information
NPI: 1992020465
Provider Name (Legal Business Name): VICTORIA ERIN GOLDEN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/29/2010
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2925 ASTORIA WAY STE 760
EDMOND OK
73034-5997
US
IV. Provider business mailing address
2925 ASTORIA WAY STE 100
EDMOND OK
73034-5997
US
V. Phone/Fax
- Phone: 405-254-3000
- Fax: 405-286-1934
- Phone: 405-254-3000
- Fax: 405-286-1934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R0082689 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: