Healthcare Provider Details

I. General information

NPI: 1154362259
Provider Name (Legal Business Name): DAWN CATHERINE CAMPBELL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S UTICA AVE
TULSA OK
74104-4012
US

IV. Provider business mailing address

1145 S UTICA AVE SUITE 110
TULSA OK
74104-4000
US

V. Phone/Fax

Practice location:
  • Phone: 918-579-8344
  • Fax: 918-579-1556
Mailing address:
  • Phone: 918-579-3825
  • Fax: 918-579-1262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR0079844
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: