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Individual

LAUREN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2345
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2345

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
103890
OK
363LF0000X
Family Nurse Practitioner
103890
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E712287
STUDENT
OK
Enumeration date
03/29/2016
Last updated
07/22/2016
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