MEDICARE: IMELDA GARNER PMHNP, 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
1	363LP2300X	Primary Care Nurse Practitioner	102275	OK
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	102275	OK

General Provider Information

NPI Number	:	1437506680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMELDA GARNER PMHNP, APRN-CNP

Provider Business Mailing Address
First Line	:	10324 GREENBRIAR PL STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7650
Country	:	US
Telephone Number	:	405-822-0480
Fax Number	:	947-222-9272

Provider Business Practice Location Address
First Line	:	10324 GREENBRIAR PL STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7650
Country	:	US
Telephone Number	:	405-822-0480
Fax Number	:	947-222-9272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	04/17/2025

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