Individual provider · Type 1 NPI

Benjamin Wagga

Psychiatric/Mental Health Nurse Practitioner · Tulsa, OK

NPI number 1114761301 Active

Practice location

4815 S Harvard Ave Ste 360
Tulsa, OK 74135-3077

Call (918) 876-0606 Map

Fax (918) 876-0604

Mailing address

PO Box 311
Jenks, OK 74037-0311

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X2024027381 (OK)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1114761301

Benjamin Wagga's National Provider Identifier is 1114761301, issued on Jun 21, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tulsa, OK. The record was last updated on Jun 21, 2024.