Individual
JUSTIN TATE ENDERSBY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 17TH ST, WOODWARD, OK 73801-2448
(580) 254-8492
Mailing address
RR 1 BOX 234, WOODWARD, OK 73801-9712
(580) 256-3956
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0084524
OK
Other
Enumeration date
06/06/2006
Last updated
07/18/2025
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