Individual
SAMIRA POLINA QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6465 S YALE AVE STE 910, TULSA, OK 74136-7823
(918) 502-3200
(918) 502-3205
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
103075
OK
363LG0600X
Gerontology Nurse Practitioner
Primary
103075
OK
Other
Enumeration date
04/26/2018
Last updated
09/07/2021
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