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General NPI Number Information
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NPI Number | 1720514219
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Entity Type | Individual
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Provider Name | KARINA MARIA JOHANNES PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 1430 TERRACE DR
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City | TULSA
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State | OK
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Zip | 74104
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Country | US
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Telephone | 918-748-8024
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Fax | 918-748-8249
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Provider Business Mailing Address
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Address Line | 1430 TERRACE DR
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City | TULSA
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State | OK
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Zip | 74104-4626
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Country | US
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Telephone | 918-748-8024
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Fax | 918-748-8249
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 2783
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License Number State | OK
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