Healthcare Provider Details

I. General information

NPI: 1972257798
Provider Name (Legal Business Name): KRYSTEN ASHLEY MESCAN APRN-FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N PORTER AVE STE 209
NORMAN OK
73071-6485
US

IV. Provider business mailing address

PO BOX 268953
OKLAHOMA CITY OK
73126-8953
US

V. Phone/Fax

Practice location:
  • Phone: 405-217-9997
  • Fax: 405-307-8520
Mailing address:
  • Phone: 405-310-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0113151
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number206869
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: