Individual
KRISTI DEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
1440 S LEWIS AVE, TULSA, OK 74104-4624
(918) 747-6429
Mailing address
4384 S 172ND EAST AVE, TULSA, OK 74134-7323
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16165
OK
Other
Enumeration date
07/04/2017
Last updated
07/04/2017
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