Provider Demographics
NPI:1598246332
Name:CANFIELD, MARAH GAIL (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MARAH
Middle Name:GAIL
Last Name:CANFIELD
Suffix:
Gender:F
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 1:2401 W WRANGLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-1917
Mailing Address - Country:US
Mailing Address - Phone:405-382-3650
Mailing Address - Fax:405-382-6028
Practice Address - Street 1:2401 W WRANGLER BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1917
Practice Address - Country:US
Practice Address - Phone:405-303-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK114009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily