Provider Demographics
NPI:1154313039
Name:MATTHEWS, ANGELA K (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:MATTHEWS
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:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-515-2222
Mailing Address - Fax:405-515-2251
Practice Address - Street 1:3400 W TECUMSEH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-515-2222
Practice Address - Fax:405-515-2251
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0034346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100048390AMedicaid
OK100048390AMedicaid