Individual
MS. MINDY DIANE EWERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Mailing address
4802 S 109TH EAST AVE, TULSA, OK 74146-5822
(918) 392-1400
(918) 392-1488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 2666
OK
363A00000X
Physician Assistant
Primary
PA-618
AR
Other
Enumeration date
03/23/2009
Last updated
04/12/2016
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