MS. CORIE DETWILER (NPI# 1891032017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891032017 |
| Entity Type | Individual |
| Full Name | MS. CORIE DETWILER |
| Credential | PA |
| Practice Address |
9716 Riverside Pkwy Tulsa OK 74137-7447 |
| Practice Telephone | 9185284897 |
| Mailing Telephone | 9182994333 |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2015-12-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
APA2180 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9716 RIVERSIDE PKWY |
| City | TULSA |
| State | OK |
| Zip Code | 74137-7447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174540744 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Orthopaedic Surgery | 9716 Riverside Pkwy, Ste 110, Tulsa, OK 74137-7447 | 2006-07-17 |
| 1487125787 | My Hanh Tran | Physician Assistant | 9716 Riverside Pkwy, Tulsa, OK 74137-7447 | 2018-12-12 |
| 1023524766 | Rachel Ireton | Physician Assistant | 9716 Riverside Pkwy, Tulsa, OK 74137-7447 | 2017-12-18 |
| 1093259509 | Ryan Nussbaum | Physician Assistant | 9716 Riverside Pkwy, Suite 100, Tulsa, OK 74137-7447 | 2016-12-19 |
| 1477865210 | Physical Rehabilitation Center On Riverside, LLC | Clinic/Center | 9716 Riverside Pkwy, 201, Tulsa, OK 74137-7397 | 2010-07-09 |
| 1316258882 | Janna K Burkus | Emergency Medicine | 9716 Riverside Pkwy, Ste 100, Tulsa, OK 74137 | 2010-06-29 |
| 1861662744 | Chad A Perkins | Specialist/Technologist, Other | 9716 Riverside Pkwy, Ste 100, Tulsa, OK 74137 | 2008-03-06 |
| 1265537757 | Alfred Gartzke | Physician Assistant | 9716 Riverside Pkwy, Ste 100, Tulsa, OK 74137 | 2006-09-13 |
| 1306952593 | Statcare Clinics of Green Country LLC | Clinic/Center | 9716 Riverside Pkwy, Suite 100, Tulsa, OK 74137-7397 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487493 | Christopher Thibeault | Physician Assistant | 10326 S Oswego Ave, Tulsa, OK 74137 | 2019-09-27 |
| 1851896237 | Leslie King | Nurse Practitioner | 4809 East 89th Street South, Suite 100, Tulsa, OK 74137 | 2018-03-27 |
| 1245756428 | Olakunle Ajanaku | Dentist | 4818 East 113th Place South, Tulsa, OK 74137 | 2017-08-18 |
| 1831610096 | Cameron Craig | Dentist | 9671 South Riverside Drive East, Tulsa, OK 74137 | 2017-06-28 |
| 1669915336 | Verum Health | Chiropractor | 5014 East 101st Street, Suite 200, Tulsa, OK 74137 | 2016-11-29 |
| 1518327014 | Richard A Felmlee | General Practice | 8955 S. College Place, Tulsa, OK 74137 | 2016-02-26 |
| 1164815395 | John F Carletti Dds Prof Corp | Dentist | 2808 E. 101st St., Tulsa, OK 74137 | 2015-03-12 |
| 1023356581 | The Bair Foundation | Exclusive Provider Organization | 2921 E. 91st St, Tulsa, OK 74137 | 2013-01-17 |
| 1588900328 | Isaac Newton Causey | Counselor | 9325 S. Erie Avenue, Tulsa, OK 74137 | 2012-12-26 |
| 1952656894 | Crystal I Phillips | Behavioral Analyst | 2921 E 91st, Tulsa, OK 74137 | 2012-07-17 |
| Find all providers in zip 74137 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1790155562 | Caldwell Medical Group of North Tulsa LLC | Physician Assistant | 8014 S 101st East Ave, Tulsa, OK 74133-4579 | 2015-10-05 |
| 1609298330 | Marci Love Deck | Physician Assistant | 2000 S Wheeling Ave Ste 1000, Tulsa, OK 74104-5648 | 2014-01-15 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1184959389 | Erin Nicole Jones | Physician Assistant | 11212 E 48th St., Oklahoma Oncology, Tulsa, OK 74146-5806 | 2009-10-06 |
| 1194901793 | Annamae Kay | Physician Assistant | 1919 South Wheeling Ave, Ste 304, Tulsa, OK 74104 | 2008-01-14 |
| 1265632129 | Oklahoma Occupational Health Center | Physician Assistant | 5640 S Memorial Dr, Tulsa, OK 74145-9001 | 2007-07-19 |
| 1962535831 | Njanja Margaret Ruenji | Physician Assistant | Morton Comprehensive Health Services, 1334 N. Lasing Ave, Tulsa, OK 74106-5907 | 2007-03-13 |
| 1740355460 | Jeri Clark Goen | Physician Assistant | 3807 S Peoria Ave, Suite G and H, Tulsa, OK 74105-3145 | 2006-11-21 |
| 1790879237 | Steven Paul Henry | Physician Assistant | 10506 South Memorial Drive, Tulsa, OK 74133 | 2006-10-02 |
| 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.