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General NPI Number Information
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NPI Number | 1588379671
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Entity Type | Individual
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Provider Name | MIKAELA WINTZ APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 1323 W 6TH AVE
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City | STILLWATER
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State | OK
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Zip | 74074-4306
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Country | US
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Telephone | 405-533-3010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 802738
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City | KANSAS CITY
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State | MO
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Zip | 64180-2738
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Country | US
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Telephone | 918-399-3627
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 266189
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 214908
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License Number State | OK
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