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Mrs. Chan Vannarath, NURSEPRACTITIONER
Gerontology Nurse Practitioner in Lawton, Oklahoma
NPI 1225542905

Chan Vannarath is a Gerontology Nurse Practitioner based in Lawton, OK and is specialized in Gerontology. Chan Vannarath practices in Lawton, OK and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Chan Vannarath is 1225542905 and holds a License No. 84017 (Oklahoma).

The current practice location address for Chan Vannarath is 4303 Pitman St, Lawton, OK and can be reached out via phone at 580-585-5600.

Location: 4303 Pitman St, Lawton, OK, 73503-4473
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225542905
Provider Name
Chan Vannarath
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
4303 Pitman St, Lawton, OK, 73503-4473
Phone Number
580-585-5600
Fax Number
Provider Enumeration Date
11/17/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1879 01 OK NURSE PRACTITIONER
institution
Provider Business Practice Location Address Details
Address
4303 Pitman St
City
Lawton
State
Oklahoma
Zip
73503-4473
Phone Number
580-585-5600
Fax Number
person
Provider Business Mailing Address Details
Address
4303 Pitman St
City
Lawton
State
Oklahoma
Zip
73503-4473
Phone Number
580-585-5600
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
84017 (Oklahoma)
Definition
Definition to come...
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