Provider Demographics
NPI:1457959785
Name:MANNING, TAMARA SCHUCK (CNP)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:SCHUCK
Last Name:MANNING
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1302
Mailing Address - Country:US
Mailing Address - Phone:405-515-6246
Mailing Address - Fax:405-515-6249
Practice Address - Street 1:119 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1302
Practice Address - Country:US
Practice Address - Phone:405-535-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46232363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care