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General NPI Number Information
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NPI Number | 1447494299
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Entity Type | Individual
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Provider Name | ANGELA JOANN FUENTES CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 8801 S 101ST EAST AVE
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City | TULSA
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State | OK
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Zip | 74133-5716
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Country | US
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Telephone | 918-294-4915
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Fax | 918-294-4947
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Provider Business Mailing Address
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Address Line | 4800 S 109TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74146-5822
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Country | US
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Telephone | 918-392-1530
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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 | 69732
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R
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License Number State | OK
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