Provider Demographics
NPI:1750008728
Name:PATTON, CRAIG WAYNE (APRN)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:WAYNE
Last Name:PATTON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 WASHINGTON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1016
Mailing Address - Country:US
Mailing Address - Phone:405-310-3735
Mailing Address - Fax:
Practice Address - Street 1:2770 WASHINGTON DR STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1016
Practice Address - Country:US
Practice Address - Phone:405-310-3735
Practice Address - Fax:405-310-3576
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210601363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health