Individual
LISA GAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3001 S DOUGLAS BLVD, BUILDING 1094, OKLAHOMA CITY, OK 73150-1003
(405) 757-9532
Mailing address
1050 E 2ND ST # 136, EDMOND, OK 73034-5313
(405) 757-9532
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
136790
MO
163WC1400X
College Health Registered Nurse
136790
MO
163WF0300X
Flight Registered Nurse
136790
MO
163WG0000X
General Practice Registered Nurse
136790
MO
163WP0808X
Psychiatric/Mental Health Registered Nurse
136790
MO
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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