Most Relevant Information
Provider Data
| NPI Number: | 1003582644 |
| Provider Name: | LISA MICHELE SAMPLE AG-ACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LG0600X |
| Specialty: | Nurse Practitioner |
| License Number: | 205023 |
Most Important Dates
| Enumeration Date: | 08/23/2021 |
| Last Updated: | 01/16/2024 |
Provider Practice Location
6161 S YALE AVE
TULSA
OK
741361902
Practice Location Phone/Fax
| Phone: | 9184942200 |
| Fax: |
Provider Mailing Location
6600 S YALE AVE STE 1400
TULSA
OK
741363331
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |