Provider Demographics
NPI:1114656881
Name:PATTEN, LESLIE RENAE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:RENAE
Last Name:PATTEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17492 NE HWY 270
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:OK
Mailing Address - Zip Code:74563
Mailing Address - Country:US
Mailing Address - Phone:918-448-2039
Mailing Address - Fax:
Practice Address - Street 1:17492 NE HWY 270
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:OK
Practice Address - Zip Code:74563
Practice Address - Country:US
Practice Address - Phone:918-448-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF06221799363LF0000X
OKR0075029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily