IndividualActive
Benjamin Wagga
NPI 1114761301 · Psychiatric/Mental Health Nurse Practitioner · Tulsa, OK
Provider details
- NPI number
- 1114761301
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 2024027381 (OK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4815 S Harvard Ave Ste 360
Tulsa, OK 74135-3077
Phone: (918) 876-0606
Fax: (918) 876-0604
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 311
Jenks, OK 74037-0311
Registry dates
- Enumerated
- 2024-06-21
- Last updated
- 2024-06-21
- Certified
- 2024-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.