Individual
MRS. DIANNE GENENE TUPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., OPA-C
Contact information
Practice address
12301 N WESTERN AVE STE 101, OKLAHOMA CITY, OK 73114-8017
(405) 757-8338
(405) 715-7179
Mailing address
175 LARY LN, GUTHRIE, OK 73044-6542
(405) 742-8898
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
83080
OK
163WX0800X
Orthopedic Registered Nurse
R0083080
OK
363AM0700X
Medical Physician Assistant
Primary
1148
OK
363AS0400X
Surgical Physician Assistant
1148
OK
Other
Enumeration date
07/19/2011
Last updated
06/08/2023
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