Individual
CARISSA RHEA ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, CPNP-AC/P
Contact information
Practice address
1200 CHILDRENS AVE STE 2F, OKLAHOMA CITY, OK 73104-4637
(405) 271-4411
Mailing address
1200 CHILDRENS AVE # 2F, OKLAHOMA CITY, OK 73104-4637
(405) 271-4411
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
94568
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200700860B
—
OK
Enumeration date
02/27/2017
Last updated
03/11/2024
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