Healthcare Provider Details

I. General information

NPI: 1831242890
Provider Name (Legal Business Name): BARBARA SEARLE HENTHORN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 MEADOW LN
EDMOND OK
73013-5423
US

IV. Provider business mailing address

3504 MEADOW LN
EDMOND OK
73013-5423
US

V. Phone/Fax

Practice location:
  • Phone: 405-348-9157
  • Fax:
Mailing address:
  • Phone: 405-348-9157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number14952
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: