Healthcare Provider Details

I. General information

NPI: 1548711021
Provider Name (Legal Business Name): SERINA MADDEN ARNP-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 STANTON L YOUNG BLVD STE 430
OKLAHOMA CITY OK
73104-5022
US

IV. Provider business mailing address

507 PINEY OAK DR
NORMAN OK
73072-4606
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6434
  • Fax: 405-271-6264
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number74462
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number74462
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: