Healthcare Provider Details

I. General information

NPI: 1881033967
Provider Name (Legal Business Name): SARAH DABNEY BENDURE RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH JACQUELINE DABNEY

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 N MAY AVE STE 110
OKLAHOMA CITY OK
73120-2734
US

IV. Provider business mailing address

9901 N MAY AVE STE 110
OKLAHOMA CITY OK
73120-2734
US

V. Phone/Fax

Practice location:
  • Phone: 405-314-0620
  • Fax:
Mailing address:
  • Phone: 405-314-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number70139
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: