Individual
ANGELA JOANN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-4915
(918) 294-4947
Mailing address
4800 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1530
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
69732
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
R
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200266670A
—
OK
Enumeration date
04/23/2009
Last updated
06/17/2019
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