Healthcare Provider Details

I. General information

NPI: 1871386805
Provider Name (Legal Business Name): MONICA LYNN ENGLEHART APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12142 S YUKON AVE
GLENPOOL OK
74033-6621
US

IV. Provider business mailing address

12142 S YUKON AVE
GLENPOOL OK
74033-6621
US

V. Phone/Fax

Practice location:
  • Phone: 918-488-8840
  • Fax: 918-488-8842
Mailing address:
  • Phone: 918-488-8840
  • Fax: 918-488-8842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number223623
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: