Provider Demographics
NPI:1225799935
Name:HIGHTOWER, RYAN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HIGHTOWER
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3662
Mailing Address - Country:US
Mailing Address - Phone:405-248-2505
Mailing Address - Fax:
Practice Address - Street 1:785 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3662
Practice Address - Country:US
Practice Address - Phone:405-248-2505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK206387363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner