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1447735055
JONATHAN DANIEL BOULDIN
TULSA, OK
NPI
1447735055
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: OK 114696)
Enumeration Date
2018-09-28
Last Update Date
2018-09-28
Business Address
JONATHAN DANIEL BOULDIN APRN-CNP
1265 S UTICA AVE
TULSA, OK 74104-4243
Phone number: 918-592-0999
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Mailing Address
JONATHAN DANIEL BOULDIN APRN-CNP
9228 S MINGO RD STE 200
TULSA, OK 74133-5722
Phone number: 918-592-0999
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