Provider Demographics
NPI:1841546637
Name:FIFER, ALEXANDRA NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:FIFER
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 1:1501 W ROGERS BLVD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-3924
Mailing Address - Country:US
Mailing Address - Phone:918-396-4122
Mailing Address - Fax:918-403-6301
Practice Address - Street 1:1501 W ROGERS BLVD
Practice Address - Street 2:SUITE 1400
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-3924
Practice Address - Country:US
Practice Address - Phone:918-396-4122
Practice Address - Fax:918-403-6301
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK82791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner