Healthcare Provider Details

I. General information

NPI: 1598942443
Provider Name (Legal Business Name): LOUANN M MARTIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOUANN M STEWART

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 MAIN ST
WOODWARD OK
73801-3046
US

IV. Provider business mailing address

1415 N WATTS
SAYRE OK
73662-1310
US

V. Phone/Fax

Practice location:
  • Phone: 580-571-8048
  • Fax: 580-571-8085
Mailing address:
  • Phone: 580-928-2044
  • Fax: 580-928-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR0064327
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number64327
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: