Provider Demographics
NPI:1134713373
Name:NITAH, FIDELIA NABI (PMHNP-BC, FNP-BC)
Entity type:Individual
Prefix:
First Name:FIDELIA
Middle Name:NABI
Last Name:NITAH
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6309
Mailing Address - Country:US
Mailing Address - Phone:405-359-5370
Mailing Address - Fax:405-359-5481
Practice Address - Street 1:1 S BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6309
Practice Address - Country:US
Practice Address - Phone:405-359-5370
Practice Address - Fax:405-359-5481
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK200703363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily