Provider Demographics
NPI:1346124880
Name:LAVIN, MATTEA LEANN (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MATTEA
Middle Name:LEANN
Last Name:LAVIN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7812
Mailing Address - Country:US
Mailing Address - Phone:918-728-4017
Mailing Address - Fax:
Practice Address - Street 1:106 BURR AVE
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-3848
Practice Address - Country:US
Practice Address - Phone:405-926-2002
Practice Address - Fax:405-365-8824
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK204237363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily