Healthcare Provider Details

I. General information

NPI: 1376406512
Provider Name (Legal Business Name): MAGDALENE MCDANIEL PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGDALENE KOKUNGA

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9210 S WESTERN AVE
OKLAHOMA CITY OK
73139-4982
US

IV. Provider business mailing address

5700 NW 154TH TERRACE
EDMOND OK
73013
US

V. Phone/Fax

Practice location:
  • Phone: 405-934-1681
  • Fax:
Mailing address:
  • Phone: 405-697-9340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226426
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: