Individual
MRS. MANDA LYNN BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
10505 E 91ST ST STE 205, TULSA, OK 74133-5829
(918) 307-5490
Mailing address
10505 E 91ST ST STE 205, TULSA, OK 74133-5829
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
R0121986
OK
363LG0600X
Gerontology Nurse Practitioner
Primary
222648
OK
Other
Enumeration date
03/25/2025
Last updated
04/08/2025
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