Provider Demographics
NPI:1750262739
Name:GRIVETTE, GARRETT MONTANA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:MONTANA
Last Name:GRIVETTE
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 PARKLAWN DR STE 302
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4230
Mailing Address - Country:US
Mailing Address - Phone:405-492-7229
Mailing Address - Fax:888-777-8306
Practice Address - Street 1:2801 PARKLAWN DR STE 302
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4230
Practice Address - Country:US
Practice Address - Phone:405-492-7229
Practice Address - Fax:888-777-8306
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK224387363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily