Individual
MARY BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
6151 S YALE AVE, SUITE A-100, TULSA, OK 74136-1907
(918) 494-8500
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R0032267
OK
363LC0200X
Critical Care Medicine Nurse Practitioner
R0032267
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100136240A
—
OK
01
—
500018800
RAILROAD MEDICARE
OK
Enumeration date
10/05/2005
Last updated
12/21/2016
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