Healthcare Provider Details

I. General information

NPI: 1164978045
Provider Name (Legal Business Name): LETICIA ENRIQUEZ ROJAS APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 E 81ST ST
TULSA OK
74137-4200
US

IV. Provider business mailing address

1800 W FORT WORTH ST
BROKEN ARROW OK
74012-8300
US

V. Phone/Fax

Practice location:
  • Phone: 918-477-5199
  • Fax:
Mailing address:
  • Phone: 918-829-8730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number103889
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: