Individual
CLINTON KAMANAO'LANA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8801 S 101 E AVE, TULSA, OK 74133
(918) 294-4915
(918) 294-4947
Mailing address
7912 E 31ST CT, STE 210, TULSA, OK 74145-1315
(918) 392-4477
(918) 392-4465
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0084773
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010672601002
BCBSOK
OK
05
—
200091050A
—
OK
Enumeration date
07/04/2006
Last updated
05/19/2008
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