Provider Demographics
NPI:1316350713
Name:YATES-GRIFFIN, ANGELA CHRISTINE (APRN, CNP)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:YATES-GRIFFIN
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:YATES-GRIFFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:121 N MEKUSUKEY AVE
Mailing Address - Street 2:
Mailing Address - City:WEWOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74884-2117
Mailing Address - Country:US
Mailing Address - Phone:405-712-0467
Mailing Address - Fax:405-257-5463
Practice Address - Street 1:121 N MEKUSUKEY AVE
Practice Address - Street 2:
Practice Address - City:WEWOKA
Practice Address - State:OK
Practice Address - Zip Code:74884-2117
Practice Address - Country:US
Practice Address - Phone:405-257-5422
Practice Address - Fax:405-257-5463
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily