=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447545546
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEAGAN WHISENANT RN, APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2011
-----------------------------------------------------
Last Update Date | 06/16/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2919 S DIVISION ST
-----------------------------------------------------
City | GUTHRIE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73044-6806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-282-8383
-----------------------------------------------------
Fax | 405-282-6790
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4717 VALLEY PARK
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73025-2095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-285-9358
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R99785
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------