Provider Demographics
NPI:1447543764
Name:MCGILL, MATTHEW D (APRN-CNS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:MCGILL
Suffix:
Gender:M
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-307-6668
Mailing Address - Fax:405-701-6170
Practice Address - Street 1:3500 HEALTHPLEX PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9738
Practice Address - Country:US
Practice Address - Phone:405-515-2222
Practice Address - Fax:405-515-2249
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0088831363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care