Individual provider Active NPI

Olesia Nikolyevna Grellner, APRN-CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1114185659
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
90690 Issued in OK
Practice address
2625 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone
(405) 945-6225
NPI assigned
May 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 90690 OK Primary

Addresses

Primary practice location

2625 General Pershing Blvd
Oklahoma City, OK 73107-6437

Mailing address

2625 General Pershing Blvd
Oklahoma City, OK 73107-6437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90690OKMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1114185659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437",
            "telephone_number": "405-945-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRELLNER",
        "first_name": "OLESIA",
        "middle_name": "NIKOLYEVNA",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-31",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "90690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.