Provider Demographics
NPI:1245985662
Name:VANHOOSE, CARRIE ANN (RN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:VANHOOSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:WHIGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14424 N MAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-5155
Mailing Address - Country:US
Mailing Address - Phone:405-757-7818
Mailing Address - Fax:
Practice Address - Street 1:14424 N MAY AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-5155
Practice Address - Country:US
Practice Address - Phone:405-757-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0117242163WP0200X
OK207009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics