Provider Demographics
NPI:1124284559
Name:GEURTS, CARRIE DAWN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:DAWN
Last Name:GEURTS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-948-0640
Mailing Address - Fax:405-948-1753
Practice Address - Street 1:3366 NW EXPRESSWAY
Practice Address - Street 2:SUITE 720
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4462
Practice Address - Country:US
Practice Address - Phone:405-948-0640
Practice Address - Fax:405-948-1753
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK77039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK77039OtherNURSING LICENSE