Individual
KARISSA MCNEAL WAGENBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
10506 S MEMORIAL DR, TULSA, OK 74133-6914
(918) 369-3200
(918) 369-3209
Mailing address
6600 S YALE AVE STE 1200, TULSA, OK 74136-3333
(918) 488-6653
(918) 488-6098
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
205796
OK
Other
Enumeration date
10/07/2021
Last updated
04/06/2022
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