# TAMMY WAGSTAFF, DNP, APRN-CNP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508405309
- **Authorized official:** TAMMY L WAGSTAFF DNP, APRN-CNP (OWNER)
- **Authorized official phone:** (405) 409-2897

## Contact information

- **Practice address:** 5705 NW 132ND ST, OKLAHOMA CITY, OK 73142-4437
- **Practice address phone:** (405) 409-2897
- **Mailing address:** 16208 JULIET DR, EDMOND, OK 73013-9235
- **Mailing address phone:** (405) 409-2897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/27/2019
- **Last updated:** 12/27/2019