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Individual

SABRINA SUSIE ROCHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9811 E 12TH ST, TULSA, OK 74128-3803
(918) 857-8891
Mailing address
9811 E 12TH ST, TULSA, OK 74128-3803
(918) 857-8891

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0068013
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
L082525187
OK
Enumeration date
02/21/2019
Last updated
02/21/2019
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