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NPI Code Detail

MEDICARE: MANDIE MELISSA GRAHAM ARNP, FNP-C

MEDICARE: MANDIE MELISSA GRAHAM ARNP, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner79285OK

General Provider Information

NPI Number : 1851525562
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDIE MELISSA GRAHAM ARNP, FNP-C
Provider Business Mailing Address
First Line : 507 ARROWHEAD DR
Second Line :
City : TUTTLE
State : OK
Zip : 73089-1000
Country : US
Telephone Number : 405-408-0240
Fax Number :
Provider Business Practice Location Address
First Line : 6161 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1902
Country : US
Telephone Number : 918-495-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2009
Last Update Date : 06/25/2026

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