Healthcare Provider Details

I. General information

NPI: 1801689658
Provider Name (Legal Business Name): MARK MEISTER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HONOR HEIGHTS DR
MUSKOGEE OK
74401-1318
US

IV. Provider business mailing address

4429 S ROCKFORD AVE
TULSA OK
74105-4134
US

V. Phone/Fax

Practice location:
  • Phone: 888-397-8387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR0102165
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: