Healthcare Provider Details

I. General information

NPI: 1437891777
Provider Name (Legal Business Name): NANA OFORI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 SOUTHWEST BLVD
TULSA OK
74107-2705
US

IV. Provider business mailing address

2345 SOUTHWEST BLVD
TULSA OK
74107-2705
US

V. Phone/Fax

Practice location:
  • Phone: 918-582-1980
  • Fax:
Mailing address:
  • Phone: 918-582-1980
  • Fax: 918-561-1289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV6373
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: