Provider Demographics
NPI:1982341848
Name:CHANG, GEANY (APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:GEANY
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E BROADWAY CT STE A
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-7931
Mailing Address - Country:US
Mailing Address - Phone:918-794-6008
Mailing Address - Fax:
Practice Address - Street 1:401 E BROADWAY CT STE A
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7931
Practice Address - Country:US
Practice Address - Phone:918-794-6008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAG02220079363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology