Individual
HOLLY RENEE LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 392-4685
(918) 392-4693
Mailing address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 392-4685
(918) 392-4693
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
09/28/2023
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