=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801514617
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA BOGNER APRN NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2022
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13301 N MERIDIAN AVE STE 501
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73120-9368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-752-0871
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13301 N MERIDIAN AVE STE 501
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73120-9368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-752-0871
-----------------------------------------------------
Fax | 405-421-0948
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WX0200X
-----------------------------------------------------
Taxonomy Name | Oncology Registered Nurse
-----------------------------------------------------
License Number | R0120713
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 327215
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 209527
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------