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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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WANAHITA, ANNA       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 6120 S YALE AVE SUITE 1210
TULSA OK 74136
TULSA OK 74136

Address last updated on 5/17/2024
Phone #: (918) 888-5211
Fax #: (918) 888-5270
County: TULSA
License: 25436
Dated: 3/5/2007
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Neurology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Katolik Atma Jaya, Fac of Med, Jakarta, Indonesia
Graduated: 7 / 1999
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY (Neurology specific)
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Cherokee Nation W.W. Hastings Hospital
Tahlequah, OK
Hillcrest Hospital South
Tulsa, OK
Hillcrest Medical Center
Tulsa, OK
McAlester Regional Health Center
McAlester, OK
Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
6120 S YALE AVE SUITE 1210
TULSA OK 74136
TULSA OK 74136

Phone #: (918) 888-5211
Fax #: (918) 888-5270
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
BRETT JONATHAN BENNETT PA 999
KARI MOORE APRN 17140
EMILY SUKU APRN 92506

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