Individual
AUDREY MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST, CSFA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4090
(918) 764-5718
Mailing address
6411 W 103RD ST N, SPERRY, OK 74073-4184
(918) 764-5718
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
100265306
OK
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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