Individual
MADELINE ANNE PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2950 S ELM PL STE 256, BROKEN ARROW, OK 74012-7871
(918) 449-4061
(918) 449-4075
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2437
OK
Other
Enumeration date
01/16/2015
Last updated
10/29/2024
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