Healthcare Provider Details

I. General information

NPI: 1528918265
Provider Name (Legal Business Name): LAINEE GRIDER BSN, RN, PCCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US

IV. Provider business mailing address

1317 NW 12TH ST
NEWCASTLE OK
73065-4266
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-1000
  • Fax:
Mailing address:
  • Phone: 405-802-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number230574
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0136732
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: