Individual
DEANA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(918) 607-6019
Mailing address
1000 N LINCOLN BLVD STE 4000, OKLAHOMA CITY, OK 73104-3252
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
96122
OK
363LF0000X
Family Nurse Practitioner
Primary
96122
OK
Other
Enumeration date
05/27/2015
Last updated
07/06/2015
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