Provider Demographics
NPI:1619969797
Name:BARNES, BECKY R (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:R
Last Name:BARNES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 470191
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74147-0191
Mailing Address - Country:US
Mailing Address - Phone:918-742-2502
Mailing Address - Fax:918-745-9750
Practice Address - Street 1:4800 S 109TH E AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146
Practice Address - Country:US
Practice Address - Phone:918-742-2502
Practice Address - Fax:918-745-9750
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0023503367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4618912OtherAETNA
OK721545605001OtherBCBS
OK721545605001OtherBCBS