MEDICARE: JULIANN MANN RN

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	163WN0002X	Neonatal Intensive Care Registered Nurse	0077022	OK
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	0077022	OK

General Provider Information

NPI Number	:	1811849896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANN MANN RN

Provider Business Mailing Address
First Line	:	12101 S HENNEY RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73165-7663
Country	:	US
Telephone Number	:	405-317-8460
Fax Number	:

Provider Business Practice Location Address
First Line	:	5224 E I 240 SERVICE RD STE 100
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-2607
Country	:	US
Telephone Number	:	405-628-6738
Fax Number	:	405-628-6576

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ JULIANN MANN RN” Practice Location

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