Provider Demographics
NPI:1891294419
Name:DEWITTE, MEREDITH ANNE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANNE
Last Name:DEWITTE
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 1:4401 MCAULEY BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8561
Mailing Address - Country:US
Mailing Address - Phone:405-936-5455
Mailing Address - Fax:405-936-5629
Practice Address - Street 1:4401 MCAULEY BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8561
Practice Address - Country:US
Practice Address - Phone:405-936-5455
Practice Address - Fax:405-936-5629
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103806363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology