Individual
MICAL ISALY PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN-CNP, PM HN
Contact information
Practice address
4922 E 73RD ST, TULSA, OK 74136-7007
(918) 340-6460
(918) 926-3376
Mailing address
4922 E 73RD ST, TULSA, OK 74136-7007
(918) 340-6460
(918) 926-3376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0125930
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
226790
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201164390A
—
OK
Enumeration date
06/13/2023
Last updated
02/26/2026
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