Provider Demographics
NPI:1780830406
Name:LAMB, MICHELLE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:LAMB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 S OSWEGO AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-5132
Mailing Address - Country:US
Mailing Address - Phone:918-688-9781
Mailing Address - Fax:
Practice Address - Street 1:7645 E 63RD ST
Practice Address - Street 2:SUITE 105
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1208
Practice Address - Country:US
Practice Address - Phone:918-592-6297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist