| Doctor Name: | LYNN ANN TUDOR |
| NPI Number: | 1386991529 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, FNP-BC |
| License Number: | 96089 |
| Business Practice Address: | 1239 W Main St Jenks, OK - 740372311 |
| Business Phone Number: | 9182910004 |
| Business Fax Number: | 9182963911 |
| Mailing Address: | 1239 W Main St, JENKS |
| State: | OK |
| Postal Code: | 740372311 |
| Phone Number: | 9182910004 |
| Fax Number: | 9182963911 |
| NPI Enumeration Date: | 08/07/2012 |
| NPI Last Update Date: | 08/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 96089 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |