Individual
MRS. SANDRA MARIE MELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APPN, FNP-BC
Contact information
Practice address
8316 E 61ST ST STE 101A, TULSA, OK 74133-1908
(918) 893-3535
(918) 893-3570
Mailing address
8316 E 61ST ST STE 101A, TULSA, OK 74133-1908
(918) 893-3535
(918) 893-3570
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
88750
OK
363LF0000X
Family Nurse Practitioner
653337
TX
363LF0000X
Family Nurse Practitioner
Primary
88750
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200623310A
—
OK
Enumeration date
06/04/2006
Last updated
01/17/2020
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