Individual
EDWARD LYNN SOMMERHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 542-6611
(918) 787-3864
Mailing address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 542-6611
(918) 787-3864
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0031193
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100699440E
—
OK
05
—
100787930A
—
OK
Enumeration date
03/14/2006
Last updated
11/17/2008
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