Provider Demographics
NPI:1871664227
Name:MATULA VEIT, NANCY M (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:MATULA VEIT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:VEIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503-4472
Mailing Address - Country:US
Mailing Address - Phone:580-558-8502
Mailing Address - Fax:580-558-3408
Practice Address - Street 1:4301 WILSON ST
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4472
Practice Address - Country:US
Practice Address - Phone:580-558-8502
Practice Address - Fax:580-558-3408
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK243709302OtherMEDICARE ID
OK243709302OtherMEDICARE ID