Basic Information
| Provider Information | |||||||||
| NPI: | 1790002434 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SURBER | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | YURAS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, APRN-CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2212 POWDERHORN | ||||||||
| Address2: | |||||||||
| City: | EDMOND | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730346803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053268213 | ||||||||
| FaxNumber: | 4055136070 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N LINCOLN BLVD STE 3400 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731043252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052711000 | ||||||||
| FaxNumber: | 4052711013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2010 | ||||||||
| LastUpdateDate: | 09/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 89442 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.