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General NPI Number Information
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NPI Number | 1114317435
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Entity Type | Individual
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Provider Name | SAVANAH BROOK PARKS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2015
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 2908 ASTORIA WAY
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City | EDMOND
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State | OK
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Zip | 73034-5997
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Country | US
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Telephone | 405-676-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 12001 SW 31ST ST
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City | YUKON
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State | OK
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Zip | 73099-3691
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Country | US
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Telephone | 405-492-0333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 65769
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License Number State | OK
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