Individual
MRS. MANDIE LEIGH RENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCNS
Contact information
Practice address
1120 S UTICA AVE STE 2123, TULSA, OK 74104
(918) 579-5402
(918) 579-5404
Mailing address
1120 S UTICA AVE STE 2123, TULSA, OK 74104-4012
(189) 579-5402
(918) 579-5404
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
80137
OK
364SN0000X
Neonatal Clinical Nurse Specialist
81378
OK
Other
Enumeration date
08/28/2008
Last updated
03/06/2019
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