Provider Demographics
NPI:1932478070
Name:MYERS, ANGELA M (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MYERS
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 1:1631 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3041
Mailing Address - Country:US
Mailing Address - Phone:580-256-6416
Mailing Address - Fax:
Practice Address - Street 1:1631 TEXAS ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3041
Practice Address - Country:US
Practice Address - Phone:580-256-6416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR66656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200417120AMedicaid