Individual provider · Type 1 NPI
Fallon Thompson
Acute Care Nurse Practitioner · Tulsa, OK
NPI number
1104578418
Active
Practice location
6161 S Yale Ave
Tulsa, OK 74136-1902
Fax (918) 494-6303
Mailing address
211 E Juneau Pl
Broken Arrow, OK 74012-8269
Other practice locations
- 1819 E 19th St Ste 500, Tulsa, OK 74104-5429 · (918) 744-3600
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 215536 (OK) |
| Registered Nurse | 163W00000X | R0136311 (OK) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1104578418
Fallon Thompson's National Provider Identifier is 1104578418, issued on Jan 19, 2022. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Tulsa, OK. The record was last updated on Oct 6, 2025.