Provider Demographics
NPI:1356896856
Name:CHOATE, WANDA SUE (APRN, NP-CNP)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:SUE
Last Name:CHOATE
Suffix:
Gender:F
Credentials:APRN, NP-CNP
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:SUE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:VIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74962-0446
Mailing Address - Country:US
Mailing Address - Phone:918-773-5226
Mailing Address - Fax:918-892-6782
Practice Address - Street 1:128 W MAIN
Practice Address - Street 2:
Practice Address - City:VIAN
Practice Address - State:OK
Practice Address - Zip Code:74962-0446
Practice Address - Country:US
Practice Address - Phone:918-421-6960
Practice Address - Fax:918-421-6963
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0076255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily