Individual
SUSANNA CAROL MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 S UTICA AVE STE 701, TULSA, OK 74104-4019
(918) 582-6544
(918) 550-7544
Mailing address
2401 W OMAHA ST APT 2315, BROKEN ARROW, OK 74012-0652
(918) 856-1385
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
82443
OK
390200000X
Student in an Organized Health Care Education/Training Program
82443
OK
Other
Enumeration date
07/15/2020
Last updated
03/30/2022
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