Basic Information
| Provider Information | |||||||||
| NPI: | 1477117638 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AARON | ||||||||
| FirstName: | MERYL | ||||||||
| MiddleName: | ELAINE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 W I 44 SERVICE RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731128766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056072233 | ||||||||
| FaxNumber: | 4052866396 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 W I 44 SERVICE RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731128766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056046000 | ||||||||
| FaxNumber: | 4052866396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2019 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | 47419 | OK | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 363LP0808X | R0047419 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.