Organization
DRAPER ANESTHESIA SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERI MOORE (CREDENTIALING SPECIALIST)
(405) 608-5329
Entity
Organization
Contact information
Practice address
14000 N PORTLAND AVE STE 102, OKLAHOMA CITY, OK 73134
(405) 418-4800
(405) 418-4820
Mailing address
PO BOX 272605, OKLAHOMA CITY, OK 73137-2605
(405) 418-4800
(405) 418-4820
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
67878
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200075290A
—
OK
01
—
20418590001
BC/BS
OK
01
—
DG1017
MEDICARE RR
OK
Enumeration date
07/10/2006
Last updated
05/31/2018
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