Deandra Lynette Antwine, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200784 Issued in OK

Practice address

591 E 36TH St N
Tulsa, OK 74106-1812

Phone

(918) 619-4400

Fax

(918) 634-7875

NPI assigned

Sep 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Board of Regents of the University of Oklahoma Ou Physicians Tulsa

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1154385730

  OK

  Medicare reassignment NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1295404994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 S QUINCY AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363803",
            "telephone_number": "918-510-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 E 36TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061812",
            "telephone_number": "918-619-4400",
            "fax_number": "918-634-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTWINE",
        "first_name": "DEANDRA",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "200784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201024480A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guy Louise Antoine
• Briche' Antol
• Anderae Rachelle Antonio
• Shamika Jeanette Antwine Boone
• Christopher Bradley Antwine
• Jasmine Antwine
• Dixitha Anugula, M.B.B.S
• Ayesha Anwaar
• Farahnaz Mortoza Anwar, MD
• Onelia Sofia Anzola, BA

• All providers in Tulsa, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.