Provider Demographics
NPI:1659536530
Name:EVERT, LUANN (RN, ARNP)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:EVERT
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N MONTE VISTA ST
Mailing Address - Street 2:VALLEY VIEW REGIONAL HOSPITAL
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4610
Mailing Address - Country:US
Mailing Address - Phone:580-421-1191
Mailing Address - Fax:580-421-6167
Practice Address - Street 1:430 N MONTE VISTA ST
Practice Address - Street 2:VALLEY VIEW REGIONAL HOSPITAL
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4610
Practice Address - Country:US
Practice Address - Phone:580-421-1191
Practice Address - Fax:580-421-6167
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner