Individual
DEANNA KAYE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 332-2323
Mailing address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 332-2323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
67133
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000728840B
—
OK
Enumeration date
02/22/2010
Last updated
10/08/2020
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