IndividualActive
Mandie Renner, CCNS
NPI 1760630131 · Critical Care Neonatal Nurse Practitioner · Tulsa, OK
Provider details
- NPI number
- 1760630131
- Entity type
- Individual
- Primary specialty
- Critical Care Neonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CCNS
- Sex
- Female
- Sole proprietor
- No
- License
- 81378 (OK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1120 S Utica Ave Ste 2123
Tulsa, OK 74104
Phone: (918) 579-5402
Fax: (918) 579-5404
Approximate (ZIP-level) locationGet directions
Mailing address
1120 S Utica Ave Ste 2123
Tulsa, OK 74104-4012
Additional practice locations (1)
- 8607 E. 104th StTulsa, OK 74113Phone: (918) 808-1881
Registry dates
- Enumerated
- 2008-08-28
- Last updated
- 2019-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.