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General NPI Number Information
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NPI Number | 1255228078
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Entity Type | Individual
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Provider Name | VIRGINIA LYNN FERNANDEZ RN
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 2414 E SHAWNEE RD
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City | MUSKOGEE
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State | OK
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Zip | 74403-1530
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Country | US
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Telephone | 918-577-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 COYOTE PASS CT
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City | MUSKOGEE
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State | OK
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Zip | 74403-8434
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Country | US
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Telephone | 914-441-6430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R0062846
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License Number State | OK
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