Individual
IAN WHITMARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-5207
Mailing address
PO BOX 7389, ATTN: REBECCA EASON CPPA, LONGVIEW, TX 75607-7389
(888) 260-6614
(903) 257-0815
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007888
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093190
REGISTERED NURSE/CRNA
OK
05
—
9655028
—
WA
01
—
AP30007888
WA LICENSE NUMBER
WA
01
—
RN00123820
RN LICENSE
WA
Enumeration date
10/30/2007
Last updated
09/09/2008
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