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NPI Code Detail

MEDICARE: CHAZ WHITE CRNA

MEDICARE:   CHAZ  WHITE  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistR84680OK

General Provider Information

NPI Number : 1073821641
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAZ WHITE CRNA
Provider Business Mailing Address
First Line : 7805 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-8061
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1120 S UTICA AVE
Second Line :
City : TULSA
State : OK
Zip : 74104-4012
Country : US
Telephone Number : 918-579-8344
Fax Number : 918-579-1556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2010
Last Update Date : 09/16/2010

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Directions to “ CHAZ WHITE CRNA” Practice Location

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