Healthcare Provider Details

I. General information

NPI: 1841001021
Provider Name (Legal Business Name): LOGAN BATLEY APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4999
US

IV. Provider business mailing address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4999
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number206585
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: