Individual
KATIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6130 E 81ST ST, TULSA, OK 74137-2101
(918) 401-1002
(918) 493-3304
Mailing address
6130 E 81ST ST, TULSA, OK 74137-2101
(918) 401-1002
(918) 493-3304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
99680
OK
Other
Enumeration date
08/05/2016
Last updated
06/08/2021
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