Most Relevant Information
Provider Data
| NPI Number: | 1003645409 |
| Provider Name: | MELISSA ISLAS |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 219615 |
Most Important Dates
| Enumeration Date: | 08/01/2024 |
| Last Updated: | 08/01/2024 |
Provider Practice Location
1120 S UTICA AVE
TULSA
OK
741044012
Practice Location Phone/Fax
| Phone: | 9185920999 |
| Fax: |
Provider Mailing Location
1714 E MONTGOMERY PL
BROKEN ARROW
OK
740121842
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |