Healthcare Provider Details

I. General information

NPI: 1083152771
Provider Name (Legal Business Name): KENDALL HURLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KENDALL STUHR

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 W ROCK CREEK RD STE 101
NORMAN OK
73072-2202
US

IV. Provider business mailing address

3650 W ROCK CREEK RD STE 101
NORMAN OK
73072-2202
US

V. Phone/Fax

Practice location:
  • Phone: 405-701-3418
  • Fax: 405-701-3451
Mailing address:
  • Phone: 405-701-3418
  • Fax: 405-701-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number115706
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number96622
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: