Healthcare Provider Details

I. General information

NPI: 1760610430
Provider Name (Legal Business Name): HOLLY ANN KUHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS HOLLY ANN DRAKE

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 E 19TH ST STE 302
TULSA OK
74104-5405
US

IV. Provider business mailing address

1515 N HARVARD AVE STE E
TULSA OK
74115-4957
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-7585
  • Fax: 918-748-7539
Mailing address:
  • Phone: 918-832-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26509
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: