Provider Demographics
NPI:1649745522
Name:AKE, CHANDRA LEIGH (ARNP)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:LEIGH
Last Name:AKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:SEILING
Mailing Address - State:OK
Mailing Address - Zip Code:73663-6345
Mailing Address - Country:US
Mailing Address - Phone:580-922-1385
Mailing Address - Fax:
Practice Address - Street 1:1611 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3064
Practice Address - Country:US
Practice Address - Phone:580-290-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK84657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily