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NPI Code Detail

MEDICARE: ANGELA UPTON APRN-CNP

MEDICARE: ANGELA UPTON APRN-CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner80665OK

General Provider Information

NPI Number : 1285099408
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA UPTON APRN-CNP
Provider Business Mailing Address
First Line : 1900 S COUNTRY CLUB RD
Second Line :
City : EL RENO
State : OK
Zip : 73036-5427
Country : US
Telephone Number : 405-295-2900
Fax Number : 405-295-2905
Provider Business Practice Location Address
First Line : 1900 S COUNTRY CLUB RD
Second Line :
City : EL RENO
State : OK
Zip : 73036-5427
Country : US
Telephone Number : 405-295-2900
Fax Number : 405-295-2905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2015
Last Update Date : 12/15/2015

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