Healthcare Provider Details

I. General information

NPI: 1811680887
Provider Name (Legal Business Name): LAUREN AUBREY ROVANG DNP, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 S YALE AVE STE 209
TULSA OK
74136-8303
US

IV. Provider business mailing address

6565 S YALE AVE STE 209
TULSA OK
74136-8303
US

V. Phone/Fax

Practice location:
  • Phone: 918-499-4856
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number212928
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: