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Tara R Henthorn
Family Nurse Practitioner in Chickasha, Oklahoma
NPI 1811530603

Tara R Henthorn is a Family Nurse Practitioner based in Altus, OK and is specialized in Family. Tara R Henthorn practices in Chickasha, OK. The NPI Number for Tara R Henthorn is 1811530603 and holds a License No. 102945 (Oklahoma).

The current practice location address for Tara R Henthorn is 411 W Grand Ave, Chickasha, OK and can be reached out via phone at 405-224-0053.

Location: 411 W Grand Ave, Chickasha, OK, 73521-3108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811530603
Provider Name
Tara R Henthorn
Credential
Provider Entity Type
Individual
Gender
Female
Address
411 W Grand Ave, Chickasha, OK, 73521-3108
Phone Number
405-224-0053
Fax Number
Provider Enumeration Date
10/24/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
411 W Grand Ave
City
Chickasha
State
Oklahoma
Zip
73018-5862
Phone Number
405-224-0053
Fax Number
person
Provider Business Mailing Address Details
Address
411 W Grand Ave
City
Chickasha
State
Oklahoma
Zip
73018-5862
Phone Number
405-224-0053
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
102945 (Oklahoma)
Definition
Definition to come...
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