Provider Demographics
NPI:1922250786
Name:WARZEL, DEANNA FUGATE (DPH)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:FUGATE
Last Name:WARZEL
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6302
Mailing Address - Country:US
Mailing Address - Phone:405-341-8490
Mailing Address - Fax:
Practice Address - Street 1:120 N BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6302
Practice Address - Country:US
Practice Address - Phone:405-341-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist