Individual
PAWANA ITANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
520 S MUSTANG RD, YUKON, OK 73099-6737
(405) 936-5910
(405) 577-2605
Mailing address
4325 NW 155TH PL, EDMOND, OK 73013-9158
(918) 740-7011
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
220127
OK
Other
Enumeration date
09/29/2023
Last updated
01/20/2025
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