Angela Mardenborough, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219885 Issued in OK

Practice address

5404 SW Lee Blvd
Lawton, OK 73505-9521

Phone

(580) 355-5242

Fax

(580) 355-5245

NPI assigned

May 31, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comanche County Hospital Authority

  dba Lawton Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lawton, OK
  • NPI 1588832869
  Medicare reassignment NPD
• Comanche County Hospital Authority

  dba Great Plains Pharmacy

  • Community/Retail Pharmacy
  • Lawton, OK
  • NPI 1427130947
  NPD
• Comanche County Healthcare

  dba Comanche County Wound Care Center

  • Surgery Physician
  • Lawton, OK
  • NPI 1285651232
  NPD (past)
• Comanche County Hospital Authority

  dba Comanche County Memorial Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1548618572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 SW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059521",
            "telephone_number": "580-355-5242",
            "fax_number": "580-355-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDENBOROUGH",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "OK",
            "license": "100136",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "219885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Maples
• Marble Works of Lawton
• Charity L Marburger-Caddo
• Rachel Marchbanks
• Sam Marco, MD
• Natalie Dawn Marek
• Zane Ryder Miller Marek
• Hailey Amanda Margavio
• Marie Detty Youth & Family Services Center, Inc.
• Lucas Marin Salcedo, DO

• Family Nurse Practitioner in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.