Provider Demographics
NPI:1225673122
Name:GOODSPEED, HANNAH R (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:R
Last Name:GOODSPEED
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SAWATZKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6201 N SANTA FE AVE STE 2020
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7532
Mailing Address - Country:US
Mailing Address - Phone:405-772-4450
Mailing Address - Fax:405-772-4459
Practice Address - Street 1:6201 N SANTA FE AVE STE 2020
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7532
Practice Address - Country:US
Practice Address - Phone:405-772-4450
Practice Address - Fax:405-772-4459
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK114328363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily