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Individual

DAVONNA WHITTENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
300 RANGER BLVD, ROLAND, OK 74954-4040
(918) 427-4601
(918) 427-1785
Mailing address
300 RANGER BLVD, ROLAND, OK 74954-4040
(918) 427-4601
(918) 427-1785

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
117278
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100680990A
OK
Enumeration date
09/23/2015
Last updated
09/23/2015
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