Individual
LEE ANN HABBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622
(918) 342-2641
Mailing address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622
(918) 342-2641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA763
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095320B
—
OK
05
—
1600763
—
OK
01
—
243521102
CMS PROVIDER NUMBER
OK
01
—
27022
OK ST BUREAU OF NARCOTICS
OK
Enumeration date
09/07/2005
Last updated
03/07/2023
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