| NPI Details | |
|---|---|
| NPI | 1679759823 |
| Gender | Male |
| Enumeration Date | 01/18/2008 |
| Last Updated | 12/05/2011 |
| Entity Type | Individual |
| Active | Over 10 years ago |
| Practice Location | |
|---|---|
| 9600 BROADWAY EXT OKLAHOMA CITY OK, 73114-7408, US |
|
| Phone | (405) 715-3610 |
| Fax | |
| Business Location | |
|---|---|
| PO BOX 13618 OKLAHOMA CITY OK, 73113-1618, US |
|
| Phone | (405) 715-3610 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 367500000X |
| License State | Oklahoma |
| License Number | 90661 |
| Remove 1679759823 NPI Number | |
According to our database, Derek Dane Freeman CRNA NPI is 1679759823, taxonomy code is 367500000X and license number is 90661, license state is located at Oklahoma. Derek Dane Freeman CRNA physically located at 9600 Broadway Ext, Oklahoma City OK, 73114-7408. NPI Number Derek Dane Freeman CRNA has the Individual type.
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1679759823 NPI number is provided on an as is basis without warranty of any kind. 1679759823 is maintained by the National Plan & Provider Enumeration System. The contents of Derek Dane Freeman CRNA are for informational purposes only.
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