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General NPI Number Information
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NPI Number | 1467361345
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Entity Type | Organization
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Legal Business Name | MULWANDA HEALTHCARE AND WELLNESS LLC
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 12220 E HWY 51
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City | COWETA
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State | OK
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Zip | 74429
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Country | US
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Telephone | 918-269-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 S SYCAMORE AVE
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City | BROKEN ARROW
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State | OK
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Zip | 74011-6037
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Country | US
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Telephone | 918-269-9180
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TONYA MARTIN
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Credential | FNP-BC
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Telephone | 918-269-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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