Individual
MS. EVELYN J FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1143 E 57TH PLACE, TULSA, OK 74105
(918) 378-4752
Mailing address
P.O. BOX 6321, TULSA, OK 74148
(918) 378-4752
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
37V899650300
OK
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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