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General NPI Number Information
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NPI Number | 1982343489
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Entity Type | Individual
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Provider Name | MICHELLE ELIZABETH DOCKRAY APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 6135 S 90TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74133-6365
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Country | US
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Telephone | 539-215-5609
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Fax | 539-233-2480
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Provider Business Mailing Address
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Address Line | 1701 RENAISSANCE BLVD
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City | EDMOND
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State | OK
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Zip | 73013-3086
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Country | US
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Telephone | 405-844-4978
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Fax | 405-844-0562
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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 | R0119709
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209160
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License Number State | OK
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