MRS. BOBBI LYNN MANGRUM (NPI# 1720359318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720359318 |
| Entity Type | Individual |
| Full Name | MRS. BOBBI LYNN MANGRUM |
| Credential | APRN-CNP |
| Practice Address |
1265 S Utica Ave Ste 300 Tulsa OK 74104-4243 |
| Mailing Address |
9228 S Mingo Rd Ste 200 Tulsa OK 74133-5722 |
| Practice Telephone | 9185920999 |
| Practice Fax Number | 9185921021 |
| Mailing Telephone | 9185920999 |
| Mailing Fax Number | 9185921021 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2018-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
81137 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1328 S York St, Muskogee, OK 744037650 | 9186830470 | 9186830475 |
| Street Address |
1265 S UTICA AVE STE 300 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447269725 | Joseph J Gard | Internal Medicine | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2006-08-05 |
| 1316551559 | Lauren Nicole Willems | Nurse Practitioner | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2020-09-04 |
| 1831666726 | Kayla Marie Rials | Physician Assistant | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2018-10-29 |
| 1982189585 | Cherri Dianne Foster | Nurse Practitioner | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2018-09-28 |
| 1356828594 | Andrea Diane Willibey | Clinical Nurse Specialist | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2018-07-20 |
| 1669974754 | Stephanie R Johnson | Physician Assistant | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2018-03-05 |
| 1437650108 | Dacia Elise Pittsley | Nurse Practitioner | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2018-02-27 |
| 1437670585 | Lauren E Stegemann | Clinical Nurse Specialist | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2017-06-29 |
| 1275066839 | Elizabeth Baird Walton | Physician Assistant | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2017-04-10 |
| 1164805834 | Natalee Pendergraft | Nurse Practitioner | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2015-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457824161 | Dawn Medi Spa, Inc | Nurse Practitioner | 1243 South Harvard Ave, Dawn Medi Spa, Inc, Tulsa, OK 74112 | 2019-01-04 |
| 1568969632 | A&m Healthcare Clinic | Nurse Practitioner | 3606 North Mlk Blvd, Tulsa, OK 74106 | 2018-04-06 |
| 1659770915 | Wanda S Guerrero | Nurse Practitioner | 1831 E 71st St Ste 305, Tulsa, OK 74136-3922 | 2014-08-21 |
| 1013359298 | Lori Ann Maxwell | Nurse Practitioner | 1245 S Utica Ave Fl 1, Tulsa, OK 74104-4214 | 2013-07-29 |
| 1750679585 | Abigail J Laymon | Nurse Practitioner | 1124 S Saint Louis Ave Ste 2, Tulsa, OK 74120-5413 | 2011-07-13 |
| 1265616064 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Nurse Practitioner | 4444 E 41st St 1st Floor Ste B, Ou Physicians Tulsa Pediatric Diabetes Center & Ha, Tulsa, OK 74135-2527 | 2007-12-28 |
| 1396783908 | Sandra Marie Mellor | Nurse Practitioner | 8316 E 61st St Ste 101a, Tulsa, OK 74133-1908 | 2006-06-04 |
| 1699757138 | Jennifer Lynn Graves | Nurse Practitioner | 5906 E 31st St, Tulsa, OK 74135-5110 | 2005-11-18 |
| 1164072534 | Melissa Dawn White | Nurse Practitioner | 1919 S Wheeling Ave Ste 606, Tulsa, OK 74104-5635 | 2019-09-17 |
| 1558828004 | Laura Diane Orrick | Nurse Practitioner | 4444 E 41st St, Tulsa, OK 74135-2527 | 2019-02-20 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.