Healthcare Provider Details

I. General information

NPI: 1245044825
Provider Name (Legal Business Name): SUSAN ECKMAN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OU HEALTH UNIVERSITY OF OKLAHOMA MEDICAL CENTER 700 NE 13 TH STREET
OKLAHOMA CITY OK
73104
US

IV. Provider business mailing address

1100 N STONEWALL AVE RM 310
OKLAHOMA CITY OK
73117-1200
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4700
  • Fax:
Mailing address:
  • Phone: 405-271-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number220115
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: