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General NPI Number Information
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NPI Number | 1306317078
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Entity Type | Individual
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Provider Name | SEAN PHILLIP KLUFA
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Gender | Male
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1800 W UNIVERSITY BLVD
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City | DURANT
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State | OK
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Zip | 74701-3006
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Country | US
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Telephone | 941-360-1566
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 W UNIVERSITY BLVD
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City | DURANT
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State | OK
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Zip | 74701-3006
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0107172
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License Number State | OK
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