Individual
NISSY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4000 W RENO AVE, OKLAHOMA CITY, OK 73107-6632
(405) 632-6688
Mailing address
3000 N GRAND BLVD, OKLAHOMA CITY, OK 73107-1818
(405) 632-6688
(405) 271-6264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0096235
OK
Other
Enumeration date
05/04/2016
Last updated
09/05/2024
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