Provider Demographics
NPI:1639670649
Name:ZLATNIK, ISABELLE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:ZLATNIK
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 1:4411 W GORE BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5977
Mailing Address - Country:US
Mailing Address - Phone:580-248-8000
Mailing Address - Fax:580-248-8001
Practice Address - Street 1:4411 W GORE BLVD STE B1
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5977
Practice Address - Country:US
Practice Address - Phone:580-248-8000
Practice Address - Fax:580-248-8001
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-25
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily