Provider Demographics
NPI:1376426601
Name:GAERTNER, NANCY EVELYN (LMSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:EVELYN
Last Name:GAERTNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:GAERTNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:11712 NW 99TH TER
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9354
Mailing Address - Country:US
Mailing Address - Phone:405-625-7153
Mailing Address - Fax:
Practice Address - Street 1:620 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3948
Practice Address - Country:US
Practice Address - Phone:405-208-4469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21669104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker