Healthcare Provider Details

I. General information

NPI: 1730003690
Provider Name (Legal Business Name): DEANNA J EMERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEANNA JEAN EMERSON LPN

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3027 S NEW HAVEN AVE
TULSA OK
74114-6131
US

IV. Provider business mailing address

3027 S NEW HAVEN AVE
TULSA OK
74114-6131
US

V. Phone/Fax

Practice location:
  • Phone: 918-746-6271
  • Fax:
Mailing address:
  • Phone: 918-746-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL0035532
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: