Healthcare Provider Details

I. General information

NPI: 1457528614
Provider Name (Legal Business Name): INGRID PATTON APRN CNP CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S WHEELING AVE STE 200
TULSA OK
74104-5656
US

IV. Provider business mailing address

2000S WHEELING AVE 200
TULSA OK
74104-5656
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-7854
  • Fax: 918-293-3116
Mailing address:
  • Phone: 918-748-7854
  • Fax: 918-293-3116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number0080567
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number80567
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: