Individual
JESSIE M WISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2345
Mailing address
1705 E 19TH ST STE 302, TULSA, OK 74104-5410
(918) 748-7585
(918) 403-6352
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R0083277
OK
363LA2100X
Acute Care Nurse Practitioner
Primary
202085
OK
364SG0600X
Gerontology Clinical Nurse Specialist
202085
OK
Other
Enumeration date
03/10/2021
Last updated
06/04/2021
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