Provider Demographics
NPI:1669827861
Name:LUTTRELL, ERIN (MS, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LUTTRELL
Suffix:
Gender:F
Credentials:MS, WHNP-BC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6697
Mailing Address - Country:US
Mailing Address - Phone:405-360-1264
Mailing Address - Fax:405-321-8683
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-360-1264
Practice Address - Fax:405-321-8683
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80047363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health