Provider Demographics
NPI:1720383581
Name:LIMKE, LARA LEIGH (CRNA)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:LEIGH
Last Name:LIMKE
Suffix:
Gender:F
Credentials:CRNA
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-717-6800
Mailing Address - Fax:405-717-7964
Practice Address - Street 1:1201 HEALTH CENTER PKWY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6381
Practice Address - Country:US
Practice Address - Phone:405-717-6800
Practice Address - Fax:405-717-7964
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK085949367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered