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General NPI Number Information
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NPI Number | 1376553453
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Entity Type | Individual
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Provider Name | HOWARD PAUL CROSS JR. CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 108546 S 4776 RD
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City | ROLAND
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State | OK
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Zip | 74954-5140
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Country | US
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Telephone | 918-427-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 108546 S 4776 RD
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City | ROLAND
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State | OK
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Zip | 74954-5140
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Country | US
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Telephone | 918-427-5242
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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 | C00327
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License Number State | AR
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