Healthcare Provider Details

I. General information

NPI: 1730604836
Provider Name (Legal Business Name): LINDSEY DENA' PEARSON APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 NE 13TH ST ORI 150
OKLAHOMA CITY OK
73117-1039
US

IV. Provider business mailing address

1122 NE 13TH ST ORI 236
OKLAHOMA CITY OK
73117-1039
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-3050
  • Fax: 405-271-8502
Mailing address:
  • Phone: 405-271-1515
  • Fax: 405-271-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number102892
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: