Provider Demographics
NPI:1003045501
Name:HARRELSON, TAMMY ANN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8121 NATIONAL AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7530
Mailing Address - Country:US
Mailing Address - Phone:405-606-2727
Mailing Address - Fax:405-606-7040
Practice Address - Street 1:14000 N PORTLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-4003
Practice Address - Country:US
Practice Address - Phone:405-606-2727
Practice Address - Fax:405-606-7040
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKF0609168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily