Organization
PSYCHIATRIC WELLNESS APRN-CNP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH MUSTACHIA APRN-CNP (OWNER)
(405) 437-2240
Entity
Organization
Contact information
Practice address
1491 S SUNNYLANE RD, DEL CITY, OK 73115-3037
(405) 437-2240
(661) 231-3153
Mailing address
1491 S SUNNYLANE RD, DEL CITY, OK 73115-3037
(405) 437-2240
(661) 231-3153
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/28/2019
Last updated
01/15/2022
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