Individual
TARA MARIE SUKUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3300 NW EXPRESSWAY, OKLAHOMA CITY, OK 73112-4418
(405) 949-3129
Mailing address
4010 FONTANA DR, OKLAHOMA CITY, OK 73116-1654
(405) 949-3129
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
71814
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861915985
—
OK
Enumeration date
07/20/2017
Last updated
12/03/2021
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