Healthcare Provider Details

I. General information

NPI: 1659296788
Provider Name (Legal Business Name): ADRIENNE GATZEMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8921 S MINGO RD
TULSA OK
74133-5841
US

IV. Provider business mailing address

8921 S MINGO RD
TULSA OK
74133-5841
US

V. Phone/Fax

Practice location:
  • Phone: 918-252-8050
  • Fax:
Mailing address:
  • Phone: 918-252-8050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberR0132416
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: