Healthcare Provider Details

I. General information

NPI: 1487125282
Provider Name (Legal Business Name): MICHAEL SCOTT ESKEW APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 PARKWAY COMMONS DR STE 100
OKLAHOMA CITY OK
73134-6036
US

IV. Provider business mailing address

14100 PARKWAY COMMONS DR STE 100
OKLAHOMA CITY OK
73134-6036
US

V. Phone/Fax

Practice location:
  • Phone: 405-607-8855
  • Fax:
Mailing address:
  • Phone: 405-607-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR0110823
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: