Individual
DALLAS EDWARD BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1919 S WHEELING AVE STE 606, TULSA, OK 74104-5635
(918) 748-7676
Mailing address
1919 S WHEELING AVE, STE 606, TULSA, OK 74104-5635
(918) 748-7676
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
79145
OK
363LA2200X
Adult Health Nurse Practitioner
Primary
79145
OK
363LG0600X
Gerontology Nurse Practitioner
79145
OK
Other
Enumeration date
03/14/2016
Last updated
05/10/2016
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