Healthcare Provider Details

I. General information

NPI: 1992278337
Provider Name (Legal Business Name): COURTNEY DAWN SCHRADER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 S MINGO RD STE 200
TULSA OK
74133-5722
US

IV. Provider business mailing address

9228 S MINGO RD STE 200
TULSA OK
74133-5722
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax:
Mailing address:
  • Phone: 918-592-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number89475
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: