Provider Demographics
NPI:1568705531
Name:MPW MEDICAL CONSULTING INC
Entity Type:Organization
Organization Name:MPW MEDICAL CONSULTING INC
Other - Org Name:MANDIE WORKS, APRN, CNP, FNP-C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MANDIE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:WORKS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNP, FNP-C
Authorized Official - Phone:405-408-0240
Mailing Address - Street 1:9105 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-4238
Mailing Address - Country:US
Mailing Address - Phone:405-408-0240
Mailing Address - Fax:405-739-8747
Practice Address - Street 1:11401 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5819
Practice Address - Country:US
Practice Address - Phone:405-473-5925
Practice Address - Fax:405-735-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1851525562OtherINDIVIDUAL NPI FOR SELF
OK200257450AMedicaid
OK200257450AMedicaid