Provider Demographics
NPI:1205343605
Name:VIRDEN, SCARLETT NICOLE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:SCARLETT
Middle Name:NICOLE
Last Name:VIRDEN
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:OK
Mailing Address - Zip Code:74637-5084
Mailing Address - Country:US
Mailing Address - Phone:918-642-3291
Mailing Address - Fax:918-642-3978
Practice Address - Street 1:40 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:OK
Practice Address - Zip Code:74637-5084
Practice Address - Country:US
Practice Address - Phone:918-642-3291
Practice Address - Fax:918-642-3978
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-07
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK93576163W00000X, 363LA2200X, 363LF0000X, 363LF0000X
KS5378389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health