Individual
MR. MATTHEW WOOD CUMMENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3115
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0101470
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016010580
NURSING LICENSE
MO
Enumeration date
02/03/2019
Last updated
12/09/2025
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