Provider Demographics
NPI:1457839490
Name:TOBEY, MICHELE (CNP, SSL)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:TOBEY
Suffix:
Gender:F
Credentials:CNP, SSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 S 66TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9236
Mailing Address - Country:US
Mailing Address - Phone:918-508-7440
Mailing Address - Fax:918-508-7448
Practice Address - Street 1:2230 HIGHWAY 412
Practice Address - Street 2:
Practice Address - City:COLCORD
Practice Address - State:OK
Practice Address - Zip Code:74338-1308
Practice Address - Country:US
Practice Address - Phone:918-422-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily