NPI 1295404994 · live from the CMS NPI Registry
Deandra Lynette Antwine, APRN-CNP
Nurse Practitioner, Family in Tulsa, OK. National Provider Identifier 1295404994, active.
NPI record
| NPI | 1295404994 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 591 E 36th St N, Tulsa, OK 74106 |
| Practice phone | 918-619-4400 |
| Mailing address | 6725 S Quincy Ave, Tulsa, OK 74136 |
| Enumerated | September 7, 2021 |
| Last updated | November 19, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | 200784 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.