Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 076731 | MO |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 48117 | OK |
NPI | 1184894511 |
---|---|
Provider Name | Ms. Beverly Ann Hunt |
First Address | Tulsa, OK 74104-4012 |
Second Address | Tulsa, OK 74133-5790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2008 |
Last Update Date | 23/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200132260A | (05) | OK |