Healthcare Provider Details

I. General information

NPI: 1861736738
Provider Name (Legal Business Name): LYNDSE MICHELE ASHLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 WASHINGTON DR STE 110
NORMAN OK
73069-1009
US

IV. Provider business mailing address

2770 WASHINGTON DR STE 100
NORMAN OK
73069-1016
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-2827
  • Fax: 866-415-9895
Mailing address:
  • Phone: 405-310-3735
  • Fax: 405-310-3576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83243
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: