Healthcare Provider Details

I. General information

NPI: 1629887344
Provider Name (Legal Business Name): HALEY NOELLE ESCHE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 24TH AVE NW
NORMAN OK
73069-6738
US

IV. Provider business mailing address

3209 24TH AVE NW
NORMAN OK
73069-6738
US

V. Phone/Fax

Practice location:
  • Phone: 405-865-4040
  • Fax: 405-865-4041
Mailing address:
  • Phone: 405-865-4040
  • Fax: 405-865-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5358
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: