Basic Information
| Provider Information | |||||||||
| NPI: | 1891294419 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEWITTE | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | APRN-CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2210 DUNCAN REGIONAL LOOP | ||||||||
| Address2: | |||||||||
| City: | DUNCAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735331564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802552229 | ||||||||
| FaxNumber: | 5802551064 | ||||||||
| Practice Location | |||||||||
| Address1: | 2115 DUNCAN REGIONAL LOOP STE 100 | ||||||||
| Address2: | |||||||||
| City: | DUNCAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735331570 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802552229 | ||||||||
| FaxNumber: | 5804708464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2018 | ||||||||
| LastUpdateDate: | 02/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | 103806 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.