Organization · Type 2 NPI
1984anw PC
Psychiatric/Mental Health Nurse Practitioner · Edmond, OK
NPI number
1295514982
Active
Practice location
15121 Traditions Lake Pkwy Ste A
Edmond, OK 73013-1197
Fax (405) 544-2310
Other practice locations
- 3555 NW 58th St Ste 140-W, Oklahoma City, OK 73112-4707 · (580) 380-8772
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
Other psychiatric/mental health nurse practitioner providers in Edmond
About NPI 1295514982
1984anw PC's National Provider Identifier is 1295514982, issued on Sep 22, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Edmond, OK. The record was last updated on Aug 19, 2026.