Individual
AUTUMN RENAE ACKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5656 S 129TH EAST AVE, BUILDING C, TULSA, OK 74134-6715
(918) 357-7378
(918) 357-7377
Mailing address
5656 S 129TH EAST AVE, BUILDING C, TULSA, OK 74134-6715
(918) 357-7378
(918) 357-7377
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1529
OK
Other
Enumeration date
05/15/2006
Last updated
09/26/2012
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