Healthcare Provider Details

I. General information

NPI: 1174450977
Provider Name (Legal Business Name): LAUREN JERICHOW APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NW 9TH ST STE 4106
OKLAHOMA CITY OK
73102-1006
US

IV. Provider business mailing address

2317 W EUBANKS ST
OKLAHOMA CITY OK
73112-7847
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-8373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number228658
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: