Provider Demographics
NPI:1942648324
Name:VINES, ANGELA DAWN (APRN-CNS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:VINES
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-515-2260
Mailing Address - Fax:405-307-6660
Practice Address - Street 1:3500 HEALTHPLEX PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9738
Practice Address - Country:US
Practice Address - Phone:405-515-2260
Practice Address - Fax:405-307-5610
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0058473364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care