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General NPI Number Information
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NPI Number | 1891988044
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Entity Type | Individual
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Provider Name | EVETA SUE DINGES NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 715 W MAIN ST SUITE S
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City | JENKS
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State | OK
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Zip | 74037-3554
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Country | US
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Telephone | 918-299-9447
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Fax | 918-299-5325
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Provider Business Mailing Address
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Address Line | 1903 S COLLEGE AVE
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City | TULSA
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State | OK
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Zip | 74104-6123
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Country | US
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Telephone | 918-744-8231
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0803115
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License Number State | OK
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