Provider Demographics
NPI:1831473149
Name:CROISANT, DEBORAH ALLEN
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ALLEN
Last Name:CROISANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1876 UTICA SQ
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1424
Mailing Address - Country:US
Mailing Address - Phone:918-392-3430
Mailing Address - Fax:918-392-3431
Practice Address - Street 1:1876 UTICA SQ
Practice Address - Street 2:SUITE 2C
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1424
Practice Address - Country:US
Practice Address - Phone:918-392-3430
Practice Address - Fax:918-392-3431
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor