Doctor Name: | SARA J MCDONALD |
NPI Number: | 1235595059 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 88110 |
Business Practice Address: | 11911 S Memorial Dr Bixby, OK - 740082030 |
Business Phone Number: | 9187790084 |
Business Fax Number: | 9189433793 |
Mailing Address: | Po Box 330131, TULSA |
State: | OK |
Postal Code: | 741330131 |
Phone Number: | 9187790084 |
Fax Number: | 9189433793 |
NPI Enumeration Date: | 01/08/2016 |
NPI Last Update Date: | 01/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 88110 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |