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1114761301
BENJAMIN WAGGA
TULSA, OK
NPI
1114761301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: OK 2024027381)
Enumeration Date
2024-06-21
Last Update Date
2024-06-21
Business Address
BENJAMIN WAGGA
4815 S HARVARD AVE STE 360
TULSA, OK 74135-3077
Phone number: 918-876-0606
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Mailing Address
BENJAMIN WAGGA
PO BOX 311
JENKS, OK 74037-0311
Phone number: 918-876-0606
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