Active NPI
Gina Marie Agnew
- Registered Nurse
- Stillwater, OK
National Provider Identifier
1124642665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R0121534
- Practice address
- 604 S Walnut St
Stillwater, OK 74074-4222 - Phone
- (405) 372-2202
- Fax
- (405) 445-3780
- NPI assigned
- Jun 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R0121534 | OK | Primary |
Addresses
Primary practice location
604 S Walnut St
Stillwater, OK 74074-4222
Mailing address
604 S Walnut St
Stillwater, OK 74074-4222
Phone (405) 372-2202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0121534 | OK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590969600000",
"number": "1124642665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 S WALNUT ST",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744222",
"telephone_number": "405-372-2202",
"fax_number": "405-445-3780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 S WALNUT ST",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744222",
"telephone_number": "405-372-2202",
"fax_number": "405-445-3780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGNEW",
"first_name": "GINA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-01",
"last_updated": "2020-06-01",
"certification_date": "2020-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "R0121534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.