=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588823074
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNA HOLZKNECHT BARELA RN, ARNP, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2008
-----------------------------------------------------
Last Update Date | 08/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6161 SOUTH YALE AVENUE SAINT FRANCIS HOSPITAL, EMERGENCY DEPARTMENT
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-494-2200
-----------------------------------------------------
Fax | 918-494-6432
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4535 DRESSLER RD NW
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44718-2545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-493-4443
-----------------------------------------------------
Fax | 330-493-8677
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 13409
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 0094079
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------