Provider Demographics
NPI:1083478473
Name:MAGNESS, MEGAN (APRN, CPNP-AC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MAGNESS
Suffix:
Gender:F
Credentials:APRN, CPNP-AC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BLEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11512 DEVONBROOK CT
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-8206
Mailing Address - Country:US
Mailing Address - Phone:405-519-2478
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-4411
Practice Address - Fax:405-271-5055
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0129771363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care