Age Erase Medical Aesthetics
NPI 1386505709ActiveOrganization· Nurse Practitioner· Tulsa, OK
Nurse Practitioner in Tulsa, Oklahoma, registered in NPPES in November 2025. The authorized official on file is Reesey Russell, APRN, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1386505709 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 24, 2025 |
| Last updated in NPPES | Mar 4, 2026 |
| Certified by provider | Mar 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OK) |
|---|
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