Basic Information
| Provider Information | |||||||||
| NPI: | 1063876985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TUBBESING | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | ROXANA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33620 ACME RD | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | OK | ||||||||
| PostalCode: | 748525702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053332410 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400 S DOUGLAS BLVD STE 304 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731501018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5056223063 | ||||||||
| FaxNumber: | 4057320022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2016 | ||||||||
| LastUpdateDate: | 04/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R0110487 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.