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Individual

JOANNA TRIPP WARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS, ARNP

Contact information

Practice address
3011 N UNION ST, PONCA CITY, OK 74601-7400
(580) 304-7067
Mailing address
3011 N UNION ST, PONCA CITY, OK 74601-7400
(580) 304-7067

Taxonomy

Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
54172
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12353876
CAQH
05
200431120A
OK
01
R0054172
APRN
OK
Enumeration date
06/10/2011
Last updated
01/07/2014
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