Healthcare Provider Details

I. General information

NPI: 1982139440
Provider Name (Legal Business Name): LAUREN CHELSEA LEWIS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE 10TH ST STE 4300
OKLAHOMA CITY OK
73104-5418
US

IV. Provider business mailing address

920 STANTON L YOUNG BLVD # WP3150
OKLAHOMA CITY OK
73104-5036
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4088
  • Fax: 405-271-4099
Mailing address:
  • Phone: 405-271-6966
  • Fax: 405-271-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number109921
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: