Makeda Gant

NPI 1003201039 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1003201039
Gender Female
Enumeration Date 04/06/2015
Last Updated 10/27/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
1129 S ASPEN AVE
BROKEN ARROW OK, 74012-4859, US
Phone (918) 764-9300
Fax (918) 764-9275
Business Location
1129 S ASPEN AVE
BROKEN ARROW OK, 74012-4859, US
Phone (918) 764-9300
Fax (866) 397-7556
Toxanomy
Taxonomy Code 363LF0000X
License State Oklahoma
License Number 116446
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According to our database, Makeda Gant NPI is 1003201039, taxonomy code is 363LF0000X and license number is 116446, license state is located at Oklahoma. Makeda Gant physically located at 1129 S Aspen Ave, Broken Arrow OK, 74012-4859. NPI Number Makeda Gant has the Individual type.

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1003201039 NPI number is provided on an as is basis without warranty of any kind. 1003201039 is maintained by the National Plan & Provider Enumeration System. The contents of Makeda Gant are for informational purposes only.