| Psychiatric Wellness Aprn-cnp Pllc | |
|
1491 S Sunnylane Rd Del City OK 73115-3037 | |
| (405) 437-2240 | |
| (661) 231-3153 |
| Full Name | Psychiatric Wellness Aprn-cnp Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1491 S Sunnylane Rd, Del City, Oklahoma |
| Authorized Official Name and Position | Elisabeth Mustachia (OWNER) |
| Authorized Official Contact | 4054372240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Wellness Aprn-cnp Pllc 1491 S Sunnylane Rd Del City OK 73115-3037 Ph: (405) 437-2240 | Psychiatric Wellness Aprn-cnp Pllc 1491 S Sunnylane Rd Del City OK 73115-3037 Ph: (405) 437-2240 |
| NPI Number | 1285273920 |
|---|---|
| Provider Enumeration Date | 12/28/2019 |
| Last Update Date | 01/15/2022 |
| Certification Date | 01/15/2022 |
| Medicare PECOS PAC ID | 0244665156 |
|---|---|
| Medicare Enrollment ID | O20200123001584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285273920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Tanya Rennie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417336348 PECOS PAC ID: 0345525366 Enrollment ID: I20170314000443 |
| Provider Name | Elisabeth Mustachia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346725595 PECOS PAC ID: 3375885015 Enrollment ID: I20190430001660 |
| Provider Name | Jennifer Christina Amato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558932483 PECOS PAC ID: 9638574650 Enrollment ID: I20210828000159 |
| Provider Name | Jeannie Rose Tallbear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003531211 PECOS PAC ID: 2567832819 Enrollment ID: I20221230001409 |
| Provider Name | Allison Marie Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922763218 PECOS PAC ID: 2264894138 Enrollment ID: I20230810000465 |
| Provider Name | Jennifer Renee Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548979081 PECOS PAC ID: 2466808860 Enrollment ID: I20231020001514 |
| Provider Name | Sarah Renee Senger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992562581 PECOS PAC ID: 9830538271 Enrollment ID: I20240417002899 |
| Provider Name | Ronda M Armendariz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649612730 PECOS PAC ID: 5799134623 Enrollment ID: I20240418000942 |
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