Healthcare Provider Details

I. General information

NPI: 1538257399
Provider Name (Legal Business Name): ERIN JUDITH TRIPPY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN JUDITH WICHMANN ARNP

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WEST TURCK BYPASS
DRUMRIGHT OK
74030-0090
US

IV. Provider business mailing address

35620 W 101ST ST S
MANNFORD OK
74044-6370
US

V. Phone/Fax

Practice location:
  • Phone: 918-352-9001
  • Fax: 918-352-9194
Mailing address:
  • Phone: 918-729-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0034063
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: