Provider Demographics
NPI:1396379467
Name:GIVENS, STARLA A (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:STARLA
Middle Name:A
Last Name:GIVENS
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:OK
Mailing Address - Zip Code:73095-0299
Mailing Address - Country:US
Mailing Address - Phone:405-314-5434
Mailing Address - Fax:
Practice Address - Street 1:3440 RC LUTTRELL DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9006
Practice Address - Country:US
Practice Address - Phone:405-360-1264
Practice Address - Fax:405-321-8683
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK67524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily