Provider Demographics
NPI:1407652316
Name:GAUL, CASSIDY DAWN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:DAWN
Last Name:GAUL
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 SKYWARD CIR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3220
Mailing Address - Country:US
Mailing Address - Phone:405-532-5423
Mailing Address - Fax:
Practice Address - Street 1:102 STARLITE DR
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-4944
Practice Address - Country:US
Practice Address - Phone:572-200-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK222209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily