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Individual

MR. TED LEE BARRETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN-CNP

Contact information

Practice address
705 W OAKLAND ST, BROKEN ARROW, OK 74012-1656
(918) 251-2666
Mailing address
12902 E 51ST ST, TULSA, OK 74134-6712
(918) 994-3476

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1216463
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200708550A
OK
Enumeration date
09/14/2016
Last updated
11/27/2024
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