Healthcare Provider Details

I. General information

NPI: 1124335393
Provider Name (Legal Business Name): DEE ANN HARDING CST-CFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 W 9TH ST
TULSA OK
74127-9020
US

IV. Provider business mailing address

414 SE WASHINGTON BLVD # 273
BARTLESVILLE OK
74006-2428
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-5412
  • Fax:
Mailing address:
  • Phone: 918-440-8939
  • Fax: 918-335-7962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberF01311
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: