Healthcare Provider Details

I. General information

NPI: 1609076751
Provider Name (Legal Business Name): SUSAN GEORGE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 08/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 NW EXPRESSWAY SUITE 200
OKLAHOMA CITY OK
73112-4493
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE SUITE 280
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 405-713-9900
  • Fax: 405-713-9920
Mailing address:
  • Phone: 405-713-9900
  • Fax: 405-713-9920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number56723
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR0056723
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: