Provider Demographics
NPI:1134478068
Name:VOGELE, TANA R (APRN)
Entity Type:Individual
Prefix:
First Name:TANA
Middle Name:R
Last Name:VOGELE
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 1:485 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:OOLOGAH
Mailing Address - State:OK
Mailing Address - Zip Code:74053-3017
Mailing Address - Country:US
Mailing Address - Phone:918-443-2261
Mailing Address - Fax:918-443-2271
Practice Address - Street 1:485 S ELM ST
Practice Address - Street 2:
Practice Address - City:OOLOGAH
Practice Address - State:OK
Practice Address - Zip Code:74053-3017
Practice Address - Country:US
Practice Address - Phone:918-443-2261
Practice Address - Fax:918-443-2271
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK82924363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200452550AMedicaid
OK200452550AMedicaid