Individual
MELANIE RENEE HANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12150 E 96TH ST N STE 101, OWASSO, OK 74055-5339
(918) 716-5437
Mailing address
4030 E 43RD ST, TULSA, OK 74135-2745
(732) 551-4026
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
8214
OK
Other
Enumeration date
03/25/2022
Last updated
09/11/2025
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