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NPI Code Detail

MEDICARE: TARA NICHOLE BJORNSON

MEDICARE: TARA NICHOLE BJORNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistOK

General Provider Information

NPI Number : 1134085590
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA NICHOLE BJORNSON
Provider Business Mailing Address
First Line : 3520 E 48TH PL APT 14
Second Line :
City : TULSA
State : OK
Zip : 74135-1952
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6128 E 38TH ST
Second Line :
City : TULSA
State : OK
Zip : 74135-5832
Country : US
Telephone Number : 844-458-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2025
Last Update Date : 12/30/2025

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Directions to “ TARA NICHOLE BJORNSON ” Practice Location

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