Healthcare Provider Details

I. General information

NPI: 1265901524
Provider Name (Legal Business Name): MICHELLE RENEE TIPPECONNIC DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 SPRINGER DR STE 300
NORMAN OK
73069-3966
US

IV. Provider business mailing address

2424 SPRINGER DR STE 102
NORMAN OK
73069-3966
US

V. Phone/Fax

Practice location:
  • Phone: 405-216-3747
  • Fax: 405-339-0377
Mailing address:
  • Phone: 405-216-3747
  • Fax: 405-339-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number102024
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: