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Individual

ROBERT EUGENE ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
Mailing address
12202 E OAK DR, CLAREMORE, OK 74019-5684
(918) 342-0314
(918) 481-5170

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
R0044766
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
44766
OK

Other

Enumeration date
06/23/2005
Last updated
01/30/2020
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