Provider Demographics
NPI:1033119052
Name:VIOLETT, CHARLYNN J (RPH)
Entity Type:Individual
Prefix:MISS
First Name:CHARLYNN
Middle Name:J
Last Name:VIOLETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12934 E 182ND ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-7731
Mailing Address - Country:US
Mailing Address - Phone:918-366-7152
Mailing Address - Fax:918-366-7167
Practice Address - Street 1:10106 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6731
Practice Address - Country:US
Practice Address - Phone:918-298-8838
Practice Address - Fax:918-298-1304
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK11971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist