Individual
ANASTASIA MARIE MEDVED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1923 S UTICA AVE FL 5, TULSA, OK 74104-6520
(918) 712-3366
Mailing address
8300 E 123RD ST S APT 331, BIXBY, OK 74008-3350
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
94687
OK
363LA2100X
Acute Care Nurse Practitioner
Primary
94687
OK
363LG0600X
Gerontology Nurse Practitioner
94687
OK
Other
Enumeration date
07/13/2019
Last updated
10/01/2019
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