Provider Demographics
NPI:1245593441
Name:SLEDGE, ANDREW MCKINLEY (CRNA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MCKINLEY
Last Name:SLEDGE
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:3866 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3825
Mailing Address - Country:US
Mailing Address - Phone:918-728-0404
Mailing Address - Fax:918-340-7104
Practice Address - Street 1:3029 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3465
Practice Address - Country:US
Practice Address - Phone:918-701-2331
Practice Address - Fax:918-417-7102
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2016-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK89173367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered