Individual
COURTNEY ROSE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4812 S 109TH EAST AVE, TULSA, OK 74146-5826
(918) 392-1400
Mailing address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1590
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2017004542
MO
363A00000X
Physician Assistant
Primary
4774
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220051883
—
MO
Enumeration date
02/07/2018
Last updated
09/12/2022
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