AUTUMN RENAE ACKERMAN (NPI# 1780635748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780635748 |
| Entity Type | Individual |
| Full Name | AUTUMN RENAE ACKERMAN |
| Other Name | AUTUMN RENAE MILLER |
| Credential | PA |
| Practice Address |
5656 S 129th East Ave Building C Tulsa OK 74134-6715 |
| Practice Telephone | 9183577378 |
| Practice Fax Number | 9183577377 |
| Mailing Telephone | 9183577378 |
| Mailing Fax Number | 9183577377 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2012-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1529 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5656 S 129TH EAST AVE BUILDING C |
| City | TULSA |
| State | OK |
| Zip Code | 74134-6715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497124515 | Kaytie Lynn Fratzke | Physician Assistant | 5656 S 129th East Ave, Tulsa, OK 74134-6715 | 2015-09-18 |
| 1811227143 | Stacey Simonson Rogers | Counselor | 5656 S 129th East Ave, Tulsa, OK 74134-6715 | 2010-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104455765 | Heather Nicole Mercer | Student in an Organized Health Care Education/Training Program | 14002 E. 21st St., Suite 1130, Tulsa, OK 74134 | 2020-04-06 |
| 1467954933 | Elizabeth Grace Severns | Student in an Organized Health Care Education/Training Program | 14002 E. 21st Street, #1140, Tulsa, OK 74134 | 2018-03-01 |
| 1639515901 | Holley Kuhn | Social Worker | 17410 E. 44th Place South, Tulsa, OK 74134 | 2013-05-14 |
| 1780029207 | Jennifer Spencer | Speech-Language Pathologist | 18926 E 49th St, Tulsa, OK 74134 | 2013-05-10 |
| 1659681385 | Debra Sue Grayson | Counselor | 3377 S 141st E Ave, Tulsa, OK 74134 | 2010-10-15 |
| 1689908121 | John E Groves | Dentist | 10125a South Sheridan Rd, Tulsa, OK 74134 | 2009-10-01 |
| 1255366373 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Family Medicine | 13702 E. 46th Place South, Bcchs Rosa Parks Elementary, Tulsa, OK 74134 | 2006-07-11 |
| 1023018819 | Melissa B Myers | Family Medicine | 4705 S 129th East Ave, Tulsa, OK 74134 | 2005-07-22 |
| 1033611512 | Christopher Jason Long | Family Medicine | 14002 E 21st St, Tulsa, OK 74134 | 2018-03-01 |
| 1578074332 | Goldencare Home Health | Adult Companion | 12929 E 21st St, Tulsa, OK 74134-1001 | 2017-10-19 |
| Find all providers in zip 74134 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1790155562 | Caldwell Medical Group of North Tulsa LLC | Physician Assistant | 8014 S 101st East Ave, Tulsa, OK 74133-4579 | 2015-10-05 |
| 1609298330 | Marci Love Deck | Physician Assistant | 2000 S Wheeling Ave Ste 1000, Tulsa, OK 74104-5648 | 2014-01-15 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1184959389 | Erin Nicole Jones | Physician Assistant | 11212 E 48th St., Oklahoma Oncology, Tulsa, OK 74146-5806 | 2009-10-06 |
| 1194901793 | Annamae Kay | Physician Assistant | 1919 South Wheeling Ave, Ste 304, Tulsa, OK 74104 | 2008-01-14 |
| 1265632129 | Oklahoma Occupational Health Center | Physician Assistant | 5640 S Memorial Dr, Tulsa, OK 74145-9001 | 2007-07-19 |
| 1962535831 | Njanja Margaret Ruenji | Physician Assistant | Morton Comprehensive Health Services, 1334 N. Lasing Ave, Tulsa, OK 74106-5907 | 2007-03-13 |
| 1740355460 | Jeri Clark Goen | Physician Assistant | 3807 S Peoria Ave, Suite G and H, Tulsa, OK 74105-3145 | 2006-11-21 |
| 1790879237 | Steven Paul Henry | Physician Assistant | 10506 South Memorial Drive, Tulsa, OK 74133 | 2006-10-02 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.