Healthcare Provider Details

I. General information

NPI: 1942882691
Provider Name (Legal Business Name): LINDSEY BUSBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 S 100TH EAST AVE STE 201
TULSA OK
74146-3629
US

IV. Provider business mailing address

4110 S 100TH EAST AVE STE 201
TULSA OK
74146-3629
US

V. Phone/Fax

Practice location:
  • Phone: 918-857-7246
  • Fax: 918-359-5828
Mailing address:
  • Phone: 918-857-7246
  • Fax: 918-359-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200519
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: