Provider Demographics
NPI:1396702189
Name:VISITING NURSE ASSOCIATION OF TULSA
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF TULSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:918-743-9810
Mailing Address - Street 1:7875 EAST 51 STREET
Mailing Address - Street 2:SUITE N3
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-7847
Mailing Address - Country:US
Mailing Address - Phone:918-743-9810
Mailing Address - Fax:918-691-6036
Practice Address - Street 1:7875 EAST 51 STREET
Practice Address - Street 2:SUITE N3
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-7847
Practice Address - Country:US
Practice Address - Phone:918-743-9810
Practice Address - Fax:918-691-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7052251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare PIN