Provider Demographics
NPI:1871702662
Name:LEE, ANITA (CST, CFA)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CST, CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 E 81ST ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4200
Mailing Address - Country:US
Mailing Address - Phone:918-477-5000
Mailing Address - Fax:918-477-5970
Practice Address - Street 1:2408 E 81ST ST
Practice Address - Street 2:SUITE 300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4200
Practice Address - Country:US
Practice Address - Phone:918-477-5000
Practice Address - Fax:918-477-5970
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK87952246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist