Individual
TEDROS ABBAY ASFAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1500 N 22ND ST, BROKEN ARROW, OK 74012-2319
(918) 640-5088
Mailing address
1500 N 22ND ST, BROKEN ARROW, OK 74012-2319
(918) 640-5088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F02230673
OK
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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