Healthcare Provider Details

I. General information

NPI: 1851525562
Provider Name (Legal Business Name): MANDIE MELISSA GRAHAM ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

507 ARROWHEAD DR
TUTTLE OK
73089-1000
US

V. Phone/Fax

Practice location:
  • Phone: 918-495-2600
  • Fax:
Mailing address:
  • Phone: 405-408-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number79285
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: