Individual
MARY JO GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6901 S OLYMPIA AVE, TULSA, OK 74132-1843
(918) 664-9892
(918) 664-2521
Mailing address
PO BOX 22063, DEPT 7175, TULSA, OK 74121-2063
(918) 664-9892
(918) 664-2521
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0066061
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100781760A
—
OK
Enumeration date
07/29/2006
Last updated
04/07/2010
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