MEDICARE: MELISSA ANNE WILSON ARNP

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	363LA2200X	Adult Health Nurse Practitioner	90970	OK
2	363LW0102X	Women's Health Nurse Practitioner	90970	OK

General Provider Information

NPI Number	:	1689842361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANNE WILSON ARNP

Provider Business Mailing Address
First Line	:	2448 E 81ST ST STE 1250
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-4348
Country	:	US
Telephone Number	:	918-982-6450
Fax Number	:	918-982-6254

Provider Business Practice Location Address
First Line	:	2448 E 81ST ST STE 1250
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-4348
Country	:	US
Telephone Number	:	918-982-6450
Fax Number	:	918-982-6254

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

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	07/13/2025

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