Vibrant Health Aprn PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

50761 Issued in OK

Legal business name

VIBRANT HEALTH APRN PC

Practice address

1822 E 15TH St Ste a
Tulsa, OK 74104-4647

Phone

(918) 591-3567

Fax

(918) 591-3568

NPI assigned

Jan 6, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth P Warren, APRN

Title

Owner

Phone

(918) 591-3567

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1811267891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S COLUMBIA AVE",
            "address_2": "STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143501",
            "telephone_number": "918-591-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 E 15TH ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044647",
            "telephone_number": "918-591-3567",
            "fax_number": "918-591-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT HEALTH APRN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-591-3567",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "50761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200413230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.