MEDICARE: SERINA MADDEN ARNP-FNP-C

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	363LF0000X	Family Nurse Practitioner	74462	OK
2	363L00000X	Nurse Practitioner	74462	OK

General Provider Information

NPI Number	:	1548711021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERINA MADDEN ARNP-FNP-C

Provider Business Mailing Address
First Line	:	507 PINEY OAK DR
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-4606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 STANTON L YOUNG BLVD STE 430
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5022
Country	:	US
Telephone Number	:	405-271-6434
Fax Number	:	405-271-6264

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

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	04/09/2026

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