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General NPI Number Information
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NPI Number | 1922370899
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Entity Type | Individual
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Provider Name | SOISANGVANE ALINA WINGARD ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 3345 TERRITORY LN
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City | EL RENO
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State | OK
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Zip | 73036-6503
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Country | US
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Telephone | 405-886-5655
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Fax | 405-252-2545
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Provider Business Mailing Address
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Address Line | 3345 TERRITORY LN
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City | EL RENO
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State | OK
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Zip | 73036-6503
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Country | US
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Telephone | 405-886-5655
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Fax | 405-252-2545
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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 | 96349
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 23157
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 96349
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License Number State | OK
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