Healthcare Provider Details

I. General information

NPI: 1508658261
Provider Name (Legal Business Name): ROBIN NATALIE PANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3244 S 148TH EAST AVE
TULSA OK
74134-4648
US

IV. Provider business mailing address

3244 S 148TH EAST AVE
TULSA OK
74134-4648
US

V. Phone/Fax

Practice location:
  • Phone: 918-760-7545
  • Fax:
Mailing address:
  • Phone: 918-760-7545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number20640
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: