MRS. MANDA LYNN BLISS (APRN-CNP) – Gerontology Nurse Practitioner, NPI 1356143978

MRS. MANDA LYNN BLISS (APRN-CNP) is a healthcare provider. based in Tulsa, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN-CNP. They hold a License No. R0121986 (OK). The NPI Number for MRS. MANDA LYNN BLISS (APRN-CNP) is 1356143978

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MANDA LYNN BLISS (APRN-CNP)
NPI
1356143978
Phone
Not provided
Address
10505 E 91ST ST STE 205
Enumeration Date
25 March 2025
Last Update Date
8 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9183075490
Graduation Year
2024 (2 years ago)
PAC ID
3779090774
Group Practice PAC ID
7618248105
Professional Enrollment ID
I20250725000232
Address ID
OK741335829TU10505STXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:1State licenses:2Digital endpointsOther names

3,328 NURSE PRACTITIONER in OK

Provider Addresses for MRS. MANDA LYNN BLISS (APRN-CNP)

  • 10505 E 91ST ST STE 205

    TULSA, OK 741335829

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-25

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250725000232INurse PractitionerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618248105View full group profile
NameSpecialtyState
Nurse PractitionerOK
Nurse PractitionerOK
Nurse PractitionerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Does MRS. MANDA LYNN BLISS (APRN-CNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. MANDA LYNN BLISS (APRN-CNP) uses 1356143978.
Is MRS. MANDA LYNN BLISS (APRN-CNP) still practicing?
MRS. MANDA LYNN BLISS (APRN-CNP) is currently listed as active in the public NPI registry.
What taxonomy line describes MRS. MANDA LYNN BLISS (APRN-CNP)?
For research purposes, treat MRS. MANDA LYNN BLISS (APRN-CNP) as Gerontology Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MRS. MANDA LYNN BLISS (APRN-CNP)?
MRS. MANDA LYNN BLISS (APRN-CNP)'s geographic hint is Tulsa, Oklahoma in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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