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General NPI Number Information
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NPI Number | 1407304827
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Entity Type | Individual
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Provider Name | TED LEE BARRETT APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 705 W OAKLAND ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1656
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Country | US
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Telephone | 918-251-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 12902 E 51ST ST
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City | TULSA
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State | OK
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Zip | 74134-6712
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Country | US
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Telephone | 918-994-3476
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F1216463
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License Number State | OK
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