Provider Demographics
NPI:1689946402
Name:NELSON, MEGAN ROSE (RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ROSE
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 S. 109TH E. AVE.
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146
Mailing Address - Country:US
Mailing Address - Phone:918-392-1513
Mailing Address - Fax:918-392-1590
Practice Address - Street 1:4812 S. 109TH E. AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146
Practice Address - Country:US
Practice Address - Phone:918-392-1400
Practice Address - Fax:918-392-1488
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0137487163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic