Provider Demographics
NPI:1699064469
Name:KALANJ, VESNA (ACNP-BC)
Entity type:Individual
Prefix:
First Name:VESNA
Middle Name:
Last Name:KALANJ
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 E I 240 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-2607
Mailing Address - Country:US
Mailing Address - Phone:405-628-6000
Mailing Address - Fax:405-608-3838
Practice Address - Street 1:5200 E I 240 SERVICE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-2607
Practice Address - Country:US
Practice Address - Phone:405-628-6000
Practice Address - Fax:405-608-3838
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74519363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200423670AMedicaid