Provider Demographics
NPI:1205874245
Name:RITCHEY, HEIDI GISELLE (CNS)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:GISELLE
Last Name:RITCHEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 S UTICA AVE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4243
Mailing Address - Country:US
Mailing Address - Phone:918-592-0999
Mailing Address - Fax:918-592-1021
Practice Address - Street 1:1265 S UTICA AVE
Practice Address - Street 2:SUITE #300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4243
Practice Address - Country:US
Practice Address - Phone:918-592-0999
Practice Address - Fax:918-592-1021
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0069577364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK401018OtherMEDICARE PTAN
OK200090830AMedicaid
OKP00642517OtherMEDICARE RAILROAD
Q03769Medicare UPIN
OK200090830AMedicaid