Provider Demographics
NPI:1194322719
Name:WOPART, SPENCER ELIJAH (APRN, CNP)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:ELIJAH
Last Name:WOPART
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Gender:M
Credentials:APRN, CNP
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Mailing Address - Street 1:1701 RENAISSANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3086
Mailing Address - Country:US
Mailing Address - Phone:405-844-4978
Mailing Address - Fax:405-844-4978
Practice Address - Street 1:9322 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-3721
Practice Address - Country:US
Practice Address - Phone:539-215-5609
Practice Address - Fax:539-233-2480
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2025-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK121897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner