Provider Demographics
NPI:1689192718
Name:MAIR, ANGELA LYNN (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LYNN
Last Name:MAIR
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:LYNN
Other - Last Name:SEDDELMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:12828 SE 21ST CT
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-6331
Mailing Address - Country:US
Mailing Address - Phone:580-763-0459
Mailing Address - Fax:
Practice Address - Street 1:1200 EVERETT DRIVE
Practice Address - Street 2:ETNP 7504
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5047
Practice Address - Country:US
Practice Address - Phone:405-271-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-09
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0095932363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care