Healthcare Provider Details

I. General information

NPI: 1417597287
Provider Name (Legal Business Name): ZAINAB ADEYEMO OGUNMAKIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6839 S CANTON AVE
TULSA OK
74136-3402
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-0612
  • Fax:
Mailing address:
  • Phone: 918-494-0612
  • Fax: 918-481-5170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1000056
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number129992
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberM0136319
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: