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Individual

EBONIE CHANELL PANKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, PMHNP, FNP

Contact information

Practice address
4013 NW EXPRESSWAY STE 105, OKLAHOMA CITY, OK 73116-2618
(405) 378-2727
(405) 378-2776
Mailing address
4013 NW EXPRESSWAY STE 105, OKLAHOMA CITY, OK 73116-2618
(405) 378-2727
(405) 378-2776

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0083510
OK
363LF0000X
Family Nurse Practitioner
251622
GA
363LF0000X
Family Nurse Practitioner
Primary
83510
OK
363LF0000X
Family Nurse Practitioner
AP135996
TX
363LF0000X
Family Nurse Practitioner
R0083510
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R0083510
OK

Other

Enumeration date
12/07/2017
Last updated
05/13/2026
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