Healthcare Provider Details

I. General information

NPI: 1043784275
Provider Name (Legal Business Name): ANGELA CAROL ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 02/05/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16161 MOFFAT DR.
LEXINGTON OK
73051-2607
US

IV. Provider business mailing address

16161 MOFFAT DR.
LEXINGTON OK
73051
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-4838
  • Fax: 405-527-4871
Mailing address:
  • Phone: 405-408-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number91120
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number91120
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: