Provider Demographics
NPI:1568027217
Name:RAKEEB, HANEEFA (RN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:HANEEFA
Middle Name:
Last Name:RAKEEB
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CEDAR LAKE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7815
Mailing Address - Country:US
Mailing Address - Phone:405-445-1210
Mailing Address - Fax:
Practice Address - Street 1:701 CEDAR LAKE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-7815
Practice Address - Country:US
Practice Address - Phone:405-445-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK220501363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health