MEDICARE: DANA L FORREST RNFA

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
1	163WR0006X	Registered Nurse First Assistant	R0085027	OK

General Provider Information

NPI Number	:	1184860066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA L FORREST RNFA

Provider Business Mailing Address
First Line	:	6585 S YALE AVE STE 1020
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-8323
Country	:	US
Telephone Number	:	918-481-2900
Fax Number	:	918-481-2985

Provider Business Practice Location Address
First Line	:	6585 S YALE AVE STE 1020
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-8323
Country	:	US
Telephone Number	:	918-481-2900
Fax Number	:	918-481-2985

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2008
Last Update Date	:	12/26/2008

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Directions to “ DANA L FORREST RNFA” Practice Location

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