Provider Demographics
NPI:1710139035
Name:TAPP, EVYNN VICTORIA (RN, ARNP)
Entity Type:Individual
Prefix:
First Name:EVYNN
Middle Name:VICTORIA
Last Name:TAPP
Suffix:
Gender:F
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:EVYNN
Other - Middle Name:VICTORIA
Other - Last Name:BOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 NE 10TH ST STE 5D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5417
Mailing Address - Country:US
Mailing Address - Phone:405-271-9493
Mailing Address - Fax:405-271-4606
Practice Address - Street 1:825 NE 10TH ST
Practice Address - Street 2:STE 5D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5417
Practice Address - Country:US
Practice Address - Phone:405-271-9493
Practice Address - Fax:405-271-4606
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0083111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily