Healthcare Provider Details

I. General information

NPI: 1154313039
Provider Name (Legal Business Name): ANGELA K MATTHEWS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD SUITE 300
NORMAN OK
73072-1810
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-2222
  • Fax: 405-515-2251
Mailing address:
  • Phone: 405-515-2222
  • Fax: 405-515-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0034346
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: