Healthcare Provider Details

I. General information

NPI: 1548176555
Provider Name (Legal Business Name): REBECCA RAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA ARIZA

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 S LYNN LANE RD
TULSA OK
74108-5111
US

IV. Provider business mailing address

345 S LYNN LANE RD
TULSA OK
74108-5111
US

V. Phone/Fax

Practice location:
  • Phone: 918-694-6637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0081164
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: