Provider Demographics
NPI:1356497291
Name:NIGHTINGALE, LYDIA DAWN (MD)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:DAWN
Last Name:NIGHTINGALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1818
Mailing Address - Country:US
Mailing Address - Phone:405-632-6688
Mailing Address - Fax:405-228-0249
Practice Address - Street 1:4023 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6038
Practice Address - Country:US
Practice Address - Phone:405-632-6688
Practice Address - Fax:405-228-0249
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23929207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology