Provider Demographics
NPI:1730490715
Name:HARPER, GERALD N (APRN-CNP)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:N
Last Name:HARPER
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OK
Mailing Address - Zip Code:74536-0219
Mailing Address - Country:US
Mailing Address - Phone:918-569-4143
Mailing Address - Fax:918-569-7552
Practice Address - Street 1:1020 N LAWSON BOULEVARD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:OK
Practice Address - Zip Code:74536-0219
Practice Address - Country:US
Practice Address - Phone:918-569-4143
Practice Address - Fax:918-569-7552
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK67042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner