Minielly, Mary Illig
Minielly, Mary Illig is an individual health care provider with primary practice located at 8100 S. Walker Avenue Building A, Oklahoma City OK 73139-9404. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Minielly, Mary Illig can be contacted via phone (405) 632-4468.Contact Information
Primary practice address
8100 S. Walker Avenue Building A
Oklahoma City OK 73139-9404
Phone: (405) 632-4468
Fax: (405) 631-4964
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | R0059137 | Oklahoma |
Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | R0059137 | Oklahoma |
Profile Details
NPI number | 1417086380 |
---|---|
LBN Legal business name | Minielly, Mary Illig |
Credentials | Advanced Practice Registered Nurse (APRN) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 5th, 2007 |
Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417086380 | NPPES |
Oklahoma | Other | 100130740A | OHCA |
Oklahoma | Other | 28812 | OHCA |
Oklahoma | Other | 100130740A | OHCA |
Oklahoma | Other | 12317438 | OHCA |
Oklahoma | Other | 1417086380 | OHCA |
Oklahoma | Other | 59137 | OHCA |
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