Provider Demographics
NPI:1588163893
Name:BIXLER, MARY (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BIXLER
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7731 E 91ST ST STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6026
Mailing Address - Country:US
Mailing Address - Phone:918-940-7297
Mailing Address - Fax:
Practice Address - Street 1:7731 E 91ST ST STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6026
Practice Address - Country:US
Practice Address - Phone:918-940-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2018-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0041845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily