Individual
ELIZABETH ANNE BOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4444 E 41ST ST, STE 2302, TULSA, OK 74135-2527
(918) 660-3150
(918) 660-3143
Mailing address
4444 E 41ST ST, STE 2302, TULSA, OK 74135-2527
(918) 660-3150
(918) 660-3143
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
116019
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200448310A
—
OK
Enumeration date
08/08/2012
Last updated
11/21/2024
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