Individual
AUDREY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-0612
Mailing address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
88440
OK
367500000X
Certified Registered Nurse Anesthetist
AP126275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344392103
—
TX
01
—
8681UM
BCBS
TX
01
—
P01745980
RR MEDICARE
TX
Enumeration date
08/18/2014
Last updated
03/11/2021
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