Individual
ANA BAILIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
17731 MACARTHUR PARK RD, EDMOND, OK 73012-2026
(915) 303-6109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
917441
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1274716270
TRICARE PRIME
—
Enumeration date
02/07/2023
Last updated
02/07/2023
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