Provider Demographics
NPI:1184324261
Name:NTANKEH, EVELYN BIH (INTERN)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:BIH
Last Name:NTANKEH
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6806
Mailing Address - Country:US
Mailing Address - Phone:405-751-1938
Mailing Address - Fax:
Practice Address - Street 1:12240 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6806
Practice Address - Country:US
Practice Address - Phone:405-751-1938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKI10150333600000X
OK20061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy