Renita Abraham
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Oklahoma City, OK
NPI 1245034453 · NPPES record last updated May 27, 2025
Key facts
- NPI
- 1245034453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 222240 (OK)
- Practice address
- 2617 General Pershing Blvd
Oklahoma City, OK 73107-6437 - Phone
- (405) 573-9905
- NPI assigned
- Apr 4, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Oklahoma County Mental Health Center
Practice addresses (Care Compare)
2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone (405) 858-2700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250829004229 | OK | Practitioner - Nurse Practitioner | 6103327150 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 222240 | OK | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Oklahoma County Mental Health Center | Current |
Accepting new patients | |
| Millennium Medical Services, L.L.C. | Past |
Accepting new patients |
Locations
2617 General Pershing Blvd
Oklahoma City, OK 73107
Phone (405) 858-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 222240 | OK | Yes |
Addresses
Primary practice location
2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Mailing address
2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Other providers in Oklahoma City, OK
- Hadeel Aboughazale
- Bincy Rennie Abraham
- Ligi Abraham
- Manoj Abraham
- Megan Elza Abraham
- Toby Abraham
- Crystal L Abram-Garcia
- Darnell Abram Jr.
- Rachel Abram
- Carrie Elizabeth Abrams
All providers in Oklahoma City, OK · Psychiatric/Mental Health Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.