Provider Demographics
NPI:1649379603
Name:PIMENTEL, NEDENA ANN NEWMAN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:NEDENA
Middle Name:ANN NEWMAN
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:NEDENA
Other - Middle Name:ANN
Other - Last Name:RITCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4500 S. 129TH EAST AVE
Mailing Address - Street 2:#100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134
Mailing Address - Country:US
Mailing Address - Phone:918-624-4042
Mailing Address - Fax:214-775-4407
Practice Address - Street 1:4500 S. 129TH EAST AVE
Practice Address - Street 2:#100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134
Practice Address - Country:US
Practice Address - Phone:918-624-4042
Practice Address - Fax:214-775-4407
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0041299364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health