Individual
TJ DANIEL LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
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
163W00000X
Registered Nurse
827582
TX
163W00000X
Registered Nurse
99187
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
99187
OK
Other
Enumeration date
10/27/2015
Last updated
01/25/2016
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