Healthcare Provider Details

I. General information

NPI: 1679315980
Provider Name (Legal Business Name): WENDY SANDERS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 COX CANYON DR
GUTHRIE OK
73044-1029
US

IV. Provider business mailing address

5905 COX CANYON DR
GUTHRIE OK
73044-1029
US

V. Phone/Fax

Practice location:
  • Phone: 405-938-8652
  • Fax:
Mailing address:
  • Phone: 405-938-8652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number218364
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: