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General NPI Number Information
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NPI Number | 1417965807
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Entity Type | Individual
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Provider Name | LISA A WHITE CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 8100 S WALKER AVE BLDG C
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-9404
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Country | US
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Telephone | 405-602-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 NW 178TH ST
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City | EDMOND
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State | OK
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Zip | 73012-8741
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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 | 67714
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License Number State | OK
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