Provider Demographics
NPI:1871796722
Name:PICKENS, LAWANDA STOVER (RNC, MS, NNP)
Entity type:Individual
Prefix:
First Name:LAWANDA
Middle Name:STOVER
Last Name:PICKENS
Suffix:
Gender:F
Credentials:RNC, MS, NNP
Other - Prefix:
Other - First Name:LAWANDA
Other - Middle Name:FAY
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-552-0155
Mailing Address - Fax:405-945-5493
Practice Address - Street 1:3300 NW EXPRESSWAY ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-949-3393
Practice Address - Fax:405-945-5493
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK363LN005X363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care