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NPI Code Detail

MEDICARE: ADDISON LORRAINE NAKASHIMA

MEDICARE: ADDISON LORRAINE NAKASHIMA
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
1207P00000XEmergency Medicine Physician9154OK
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1295458008
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADDISON LORRAINE NAKASHIMA
Provider Business Mailing Address
First Line : 13526 N 130TH EAST AVE
Second Line :
City : COLLINSVILLE
State : OK
Zip : 74021-4492
Country : US
Telephone Number : 918-633-5560
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W 17TH ST
Second Line :
City : TULSA
State : OK
Zip : 74107-1886
Country : US
Telephone Number : 918-633-5560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2022
Last Update Date : 03/09/2026

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Directions to “ ADDISON LORRAINE NAKASHIMA ” Practice Location

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