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Organization
TAMMY WAGSTAFF, DNP, APRN-CNP, PLLC
Active
Organization
TAMMY WAGSTAFF, DNP, APRN-CNP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY L WAGSTAFF DNP, APRN-CNP (OWNER)
(405) 409-2897
Entity
Organization
Contact information
Practice address
5705 NW 132ND ST, OKLAHOMA CITY, OK 73142-4437
(405) 409-2897
Mailing address
16208 JULIET DR, EDMOND, OK 73013-9235
(405) 409-2897
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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