Provider Demographics
NPI:1801514617
Name:BOGNER, ANGELA (APRN NP-C)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BOGNER
Suffix:
Gender:F
Credentials:APRN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13301 N MERIDIAN AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9368
Mailing Address - Country:US
Mailing Address - Phone:405-752-0871
Mailing Address - Fax:405-421-0948
Practice Address - Street 1:13301 N MERIDIAN AVE STE 501
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9368
Practice Address - Country:US
Practice Address - Phone:405-752-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0120713163WX0200X
OK209527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology