| NPI | 1255125019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY BIA Part Owner 918-633-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QS1201X Family Medicine, Sleep Medicine | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-09-05 |