Healthcare Provider Details

I. General information

NPI: 1841292331
Provider Name (Legal Business Name): MS. CHARLENE FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 N LANSING AVE
TULSA OK
74106-5907
US

IV. Provider business mailing address

1334 N LANSING AVE
TULSA OK
74106-5907
US

V. Phone/Fax

Practice location:
  • Phone: 918-587-2171
  • Fax: 918-295-6149
Mailing address:
  • Phone: 918-587-2171
  • Fax: 918-295-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number749
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: