MEDICARE: RENEE MICHELLE ESTES APRN FNP-C

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	363LF0000X	Family Nurse Practitioner	222633	OK

General Provider Information

NPI Number	:	1770385981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE MICHELLE ESTES APRN FNP-C

Provider Business Mailing Address
First Line	:	8900 SE 15TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-8002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8900 SE 15TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-8002
Country	:	US
Telephone Number	:	405-737-0240
Fax Number	:

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

Provider Enumeration Date	:	03/26/2025
Last Update Date	:	04/18/2025

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