Provider Demographics
NPI:1790413011
Name:HARI, SIMRAN BHARAT (PA)
Entity type:Individual
Prefix:
First Name:SIMRAN
Middle Name:BHARAT
Last Name:HARI
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-8196
Mailing Address - Country:US
Mailing Address - Phone:405-715-2000
Mailing Address - Fax:405-715-2010
Practice Address - Street 1:301 E WATERLOO RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-8196
Practice Address - Country:US
Practice Address - Phone:405-715-2000
Practice Address - Fax:405-715-2010
Is Sole Proprietor?:No
Enumeration Date:2022-08-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant