Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 18599 | OK |
NPI | 1205826054 |
---|---|
Provider Name | Eva K Earls |
First Address | Okmulgee, OK 74447-1312 |
Second Address | Okmulgee, OK 74447-6303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 14/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100114460A | (05) | OK |
F61070 | (02) |