Provider Demographics
NPI:1841350592
Name:MCENDREE, BARBARA ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:MCENDREE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 WILLOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-7036
Mailing Address - Country:US
Mailing Address - Phone:405-364-2256
Mailing Address - Fax:405-321-1360
Practice Address - Street 1:1010 SW SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-1531
Practice Address - Country:US
Practice Address - Phone:580-248-5890
Practice Address - Fax:580-585-6621
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0025855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200052540AMedicaid
OKOK2008231060Medicare UPIN
OK200052540AMedicaid
OKS67034Medicare UPIN