Provider Demographics
NPI:1508065756
Name:FRAWNER, GLENNA J
Entity Type:Individual
Prefix:MS
First Name:GLENNA
Middle Name:J
Last Name:FRAWNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 S WESTERN AVE STE H
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2546
Mailing Address - Country:US
Mailing Address - Phone:405-550-3922
Mailing Address - Fax:
Practice Address - Street 1:8121 S WESTERN AVE STE H
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2546
Practice Address - Country:US
Practice Address - Phone:405-550-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27332B00000X
OK20335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies