Healthcare Provider Details

I. General information

NPI: 1487570388
Provider Name (Legal Business Name): MRS. SPENCER FEHRLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 W 9TH ST
TULSA OK
74127-9020
US

IV. Provider business mailing address

23021 E 102ND PL S
BROKEN ARROW OK
74014-2444
US

V. Phone/Fax

Practice location:
  • Phone: 918-932-3700
  • Fax:
Mailing address:
  • Phone: 918-998-3616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number4923
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: