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Contact Information

TAMARA L BENNETT NOLLEY, PA-C
10901 E 48TH ST
TULSA, OK74146-5830
 Phone: 918-749-8765
 Fax: 918-392-2155
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TAMARA L BENNETT NOLLEY · (Female)

NPI Number 1598061301
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 01/27/2011
Last updated 07/06/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 1994
  • OK Medicaid 2003626020A
Hospital affiliation(s)
  • ST JOHN MEDICAL CENTER INC - (Acute Care)
    1923 SOUTH UTICA AVENUE
    TULSA, OK 74104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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