Healthcare Provider Details

I. General information

NPI: 1336550508
Provider Name (Legal Business Name): JOHNNY EDWARD PATTERSON JR. APN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15951 LITTLE AXE DR
NORMAN OK
73026-9088
US

IV. Provider business mailing address

15951 LITTLE AXE DR
NORMAN OK
73026-9088
US

V. Phone/Fax

Practice location:
  • Phone: 405-447-0300
  • Fax:
Mailing address:
  • Phone: 405-447-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP013760
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226340
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0000126
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: