Individual
CANDACE M CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.S.
Contact information
Practice address
1265 S UTICA AVE, SUITE 300, TULSA, OK 74104-4243
(918) 592-0999
(918) 592-1021
Mailing address
9228 S MINGO RD, SUITE 200, TULSA, OK 74133-5718
(918) 592-0999
(918) 878-2499
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R0051791
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100850620A
—
OK
01
—
OK400768
MEDICARE PTAN
OK
01
—
P00117501
MEDICARE RAILROAD
OK
01
—
P00611404
MEDICARE RAILROAD
OK
Enumeration date
01/27/2006
Last updated
10/28/2008
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