Provider Demographics
NPI:1801581004
Name:HARGIS, JUDY RACHELE (APRN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:RACHELE
Last Name:HARGIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:918-787-1909
Mailing Address - Fax:918-787-3866
Practice Address - Street 1:10 E 13TH ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-5300
Practice Address - Country:US
Practice Address - Phone:918-786-1909
Practice Address - Fax:918-787-3866
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0102625163W00000X
OK212813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse