Healthcare Provider Details

I. General information

NPI: 1811968977
Provider Name (Legal Business Name): VERONICA LYNN WELLS RN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA LYNN RANKIN RN, CNS

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 E 41 ST STE 2G12
TULSA OK
74135
US

IV. Provider business mailing address

PO BOX 268838
OKLAHOMA CITY OK
73126-8838
US

V. Phone/Fax

Practice location:
  • Phone: 918-660-3617
  • Fax: 918-660-3631
Mailing address:
  • Phone: 918-660-3632
  • Fax: 918-660-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR0042762
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: