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General NPI Number Information
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NPI Number | 1609313824
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Entity Type | Individual
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Provider Name | ANNA BROOKE VASS PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1221 ARLINGTON ST STE B
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City | ADA
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State | OK
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Zip | 74820-4067
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Country | US
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Telephone | 580-436-5111
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Fax | 580-436-1159
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Provider Business Mailing Address
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Address Line | 527 W 3RD ST
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City | KONAWA
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State | OK
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Zip | 74849-1415
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Country | US
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Telephone | 809-253-2865
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Fax | 580-925-9149
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | OK
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