Healthcare Provider Details

I. General information

NPI: 1568939395
Provider Name (Legal Business Name): CYNTHIA GUERRERO APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S DIMPLE DR
OKLAHOMA CITY OK
73135-2461
US

IV. Provider business mailing address

PO BOX 30589
MIDWEST CITY OK
73140-3589
US

V. Phone/Fax

Practice location:
  • Phone: 405-674-2028
  • Fax: 405-674-2048
Mailing address:
  • Phone: 405-395-0399
  • Fax: 405-395-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number90841
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number90841
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: