Provider Demographics
NPI:1477221935
Name:BASS, KEELEY ERIN (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KEELEY
Middle Name:ERIN
Last Name:BASS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:KEELEY
Other - Middle Name:ERIN
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5201 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-2004
Mailing Address - Country:US
Mailing Address - Phone:405-755-4050
Mailing Address - Fax:405-749-9566
Practice Address - Street 1:5201 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2004
Practice Address - Country:US
Practice Address - Phone:405-755-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0120224163W00000X
OK205659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse