Provider Demographics
NPI:1851732036
Name:POE, REBECCA KAY (APRN CNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KAY
Last Name:POE
Suffix:
Gender:F
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 1:2107 HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3301
Mailing Address - Country:US
Mailing Address - Phone:405-397-5776
Mailing Address - Fax:405-701-7165
Practice Address - Street 1:2824 CLASSEN BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4059
Practice Address - Country:US
Practice Address - Phone:405-701-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily