Active NPI
Lisa Wood, LPN
- Licensed Practical Nurse
- Broken Arrow, OK
National Provider Identifier
1982121448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 58766
- Practice address
- 1907 S Nyssa PL
Broken Arrow, OK 74012-9094 - Phone
- (918) 688-6803
- Fax
- (918) 688-6803
- NPI assigned
- Aug 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 58766 | OK | Primary |
Addresses
Primary practice location
1907 S Nyssa PL
Broken Arrow, OK 74012-9094
Mailing address
1907 S Nyssa PL
Broken Arrow, OK 74012-9094
Phone (918) 688-6803
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 |
|---|---|---|---|
| 58766 | OK | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503619200000",
"number": "1982121448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 S NYSSA PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740129094",
"telephone_number": "918-688-6803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 S NYSSA PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740129094",
"telephone_number": "918-688-6803",
"fax_number": "918-688-6803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "LISA",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-25",
"last_updated": "2017-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OK",
"license": "58766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.