Healthcare Provider Details

I. General information

NPI: 1497186977
Provider Name (Legal Business Name): LINDSAY MARIE GAVIT APRN-CNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MARIE CORLEY

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SW 30TH CT
MOORE OK
73160-2887
US

IV. Provider business mailing address

1105 SW 30TH CT
MOORE OK
73160-2887
US

V. Phone/Fax

Practice location:
  • Phone: 405-378-2727
  • Fax:
Mailing address:
  • Phone: 405-378-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number764051
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR0111271
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR0111271
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: