Healthcare Provider Details

I. General information

NPI: 1942275409
Provider Name (Legal Business Name): WENDY J PINGLETON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 03/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36640 HWY 270
WEWOKA OK
74884
US

IV. Provider business mailing address

PO BOX 1475
WEWOKA OK
74884
US

V. Phone/Fax

Practice location:
  • Phone: 405-257-6282
  • Fax: 405-257-3344
Mailing address:
  • Phone: 405-257-6282
  • Fax: 405-257-3344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0073222
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: