Healthcare Provider Details

I. General information

NPI: 1891294419
Provider Name (Legal Business Name): MEREDITH ANNE DEWITTE APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 MCAULEY BLVD STE 2200
OKLAHOMA CITY OK
73120-8561
US

IV. Provider business mailing address

4401 MCAULEY BLVD STE 2200
OKLAHOMA CITY OK
73120-8561
US

V. Phone/Fax

Practice location:
  • Phone: 405-936-5455
  • Fax: 405-936-5629
Mailing address:
  • Phone: 405-936-5455
  • Fax: 405-936-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number103806
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number103806
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: