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Individual

CARLEEN D CARLISLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 403-0383
Mailing address
1717 S UTICA AVE STE A, TULSA, OK 74104-5346
(918) 748-7557
(918) 403-0383

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0076525
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200036720A
OK
05
200036720B
OK
Enumeration date
05/11/2006
Last updated
02/01/2019
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