Provider Demographics
NPI:1558827352
Name:WHITEMAN, ANGELIA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:MARIE
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:MARIE
Other - Last Name:LIMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:659 HEREFORD DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-8424
Mailing Address - Country:US
Mailing Address - Phone:580-512-8910
Mailing Address - Fax:
Practice Address - Street 1:3401 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6332
Practice Address - Country:US
Practice Address - Phone:580-355-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK109613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily