Provider Demographics
NPI:1861851750
Name:GEORGE, RADONA ERIN (APRN-CNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:RADONA
Middle Name:ERIN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-2524
Mailing Address - Country:US
Mailing Address - Phone:580-747-2099
Mailing Address - Fax:
Practice Address - Street 1:2111 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-2524
Practice Address - Country:US
Practice Address - Phone:580-747-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33455542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily