Provider Demographics
NPI:1063876985
Name:TUBBESING, MONICA ROXANA (APRN)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:ROXANA
Last Name:TUBBESING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33620 ACME RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:OK
Mailing Address - Zip Code:74852-5702
Mailing Address - Country:US
Mailing Address - Phone:405-333-2410
Mailing Address - Fax:
Practice Address - Street 1:3400 S DOUGLAS BLVD STE 304
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73150-1018
Practice Address - Country:US
Practice Address - Phone:505-622-3063
Practice Address - Fax:405-732-0022
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0110487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily