Healthcare Provider Details

I. General information

NPI: 1194386029
Provider Name (Legal Business Name): DEBORAH S HARRINGTON APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1239 S TRENTON AVE
TULSA OK
74120-5420
US

IV. Provider business mailing address

14472 S GARY CT
BIXBY OK
74008-8036
US

V. Phone/Fax

Practice location:
  • Phone: 918-588-8873
  • Fax:
Mailing address:
  • Phone: 405-431-7197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number114923
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114923
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: