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Individual

TINA L SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1202 N MUSKOGEE PL, CLAREMORE, OK 74017-3058
(918) 392-4456
(918) 392-4465
Mailing address
7912 E 31ST CT, STE. 210, TULSA, OK 74145-1315
(918) 392-4456
(918) 392-4465

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0044810
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100785450B
OK
01
1285810051
MEDICARE GROUP PIN
OK
Enumeration date
02/15/2006
Last updated
05/16/2008
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