MEDICARE: BRITTNEY MALLOY APRN-CNP

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
1	363L00000X	Nurse Practitioner	R0097302	OK

General Provider Information

NPI Number	:	1497306047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY MALLOY APRN-CNP

Provider Business Mailing Address
First Line	:	11011 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2714
Country	:	US
Telephone Number	:	918-878-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	11011 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2714
Country	:	US
Telephone Number	:	918-878-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2019
Last Update Date	:	03/05/2025

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