Healthcare Provider Details

I. General information

NPI: 1801287701
Provider Name (Legal Business Name): HEATHER JEAN GOYNE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER JEAN WALKER APRN

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W CHEROKEE ST
LINDSAY OK
73052-5042
US

IV. Provider business mailing address

PO BOX 302
ALEX OK
73002-0302
US

V. Phone/Fax

Practice location:
  • Phone: 405-756-1404
  • Fax: 405-756-1921
Mailing address:
  • Phone: 405-756-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number87842
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number87842
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number87842
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number87842
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: