Healthcare Provider Details

I. General information

NPI: 1124788336
Provider Name (Legal Business Name): ANGELA K NOONER DNP, APRN, ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

3450 PALOMINO WAY
NORMAN OK
73071-5080
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6796
  • Fax:
Mailing address:
  • Phone: 405-570-2105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number99455
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: