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General NPI Number Information
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NPI Number | 1093198939
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Entity Type | Individual
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Provider Name | AIMEE MUSGROVE APRN-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 2025 E 71ST ST
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City | TULSA
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State | OK
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Zip | 74136-5407
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Country | US
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Telephone | 918-561-6642
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Fax |
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Provider Business Mailing Address
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Address Line | 6528 E 101ST ST STE 1
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City | TULSA
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State | OK
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Zip | 74133-6724
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Country | US
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Telephone | 918-382-5588
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Fax | 918-382-5597
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 83052
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 83052
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 83052
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License Number State | OK
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