Provider Demographics
NPI:1497170575
Name:CHARLTON, SECUNDA LEAH (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:SECUNDA
Middle Name:LEAH
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:CHARLTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-713-7060
Mailing Address - Fax:405-713-7064
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-713-7060
Practice Address - Fax:405-713-7064
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79461363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics