Individual
VICKY B CHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
591 E 36TH ST N, TULSA, OK 74106-1812
(918) 619-4400
(918) 634-7875
Mailing address
12324 E 86TH ST N # 449, OWASSO, OK 74055-2543
(559) 349-0883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
205275
OK
Other
Enumeration date
09/21/2021
Last updated
10/20/2021
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