Provider Demographics
NPI:1609161660
Name:FISHER, ANNE MOWRY (NP-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MOWRY
Last Name:FISHER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MEREDITH
Other - Last Name:MOWRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6475 S YALE AVE STE 401
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7818
Practice Address - Country:US
Practice Address - Phone:918-502-9555
Practice Address - Fax:918-502-9559
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0101369363LA2100X, 363LA2100X
TX729635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX849N64OtherBCBS-TX
TX8N0054OtherBLUE CROSS BLUE SHIELD
TX1609161660OtherTRICARE - SOUTH
TXTXB141545Medicare PIN