Individual
MRS. DEANDRA LYNETTE ANTWINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
591 E 36TH ST N, TULSA, OK 74106-1812
(918) 619-4400
(918) 634-7875
Mailing address
6725 S QUINCY AVE, TULSA, OK 74136-3803
(918) 510-8266
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200784
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201024480A
—
OK
Enumeration date
09/07/2021
Last updated
11/19/2024
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