Individual
MR. GARY WAYNE GULICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5501 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2074
(405) 604-6000
Mailing address
4500 S GARNETT RD, SUITE 300, TULSA, OK 74146-5229
(844) 625-2312
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
75560
OK
367500000X
Certified Registered Nurse Anesthetist
85310
TX
Other
Enumeration date
02/01/2011
Last updated
08/13/2015
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