Most Relevant Information
Provider Data
| NPI Number: | 1003584244 |
| Provider Name: | SASHA LOUNMALA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 53-80085-082 |
Most Important Dates
| Enumeration Date: | 09/02/2021 |
| Last Updated: | 09/08/2021 |
Provider Practice Location
1011 HONOR HEIGHTS DR # 118
MUSKOGEE
OK
744011318
Practice Location Phone/Fax
| Phone: | 9183482236 |
| Fax: |
Provider Mailing Location
PO BOX 364
BIXBY
OK
740080364
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |