Provider Demographics
NPI:1649372632
Name:EMPSON, CAROL DEANN (LPN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:DEANN
Last Name:EMPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:FLESSNER
Other - Last Name:EMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:5780 S PEORIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7857
Mailing Address - Country:US
Mailing Address - Phone:918-858-5200
Mailing Address - Fax:918-582-4921
Practice Address - Street 1:818 S ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4803
Practice Address - Country:US
Practice Address - Phone:918-258-2952
Practice Address - Fax:918-258-4729
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0026445164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse