Individual provider · Type 1 NPI

Nicole Lisette Mancinelli, PA-C

Surgical Physician Assistant · Tulsa, OK

NPI number 1619216272 Active

Practice location

2424 E. 21st Street, Suite 320
Tulsa, OK 74114

Call (918) 392-4547 Map

Fax (918) 392-4555

Mailing address

2909 E 97th Ct, Apt. 2212
Tulsa, OK 74137-7435

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X2195 (OK)
Surgical Physician Assistant Primary 363AS0400X2195 (OK)

Surgical Physician Assistant: Definition to come...

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About NPI 1619216272

Nicole Lisette Mancinelli, PA-C's National Provider Identifier is 1619216272, issued on Feb 1, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Tulsa, OK. The record was last updated on Sep 14, 2016.