Most Relevant Information
Provider Data
| NPI Number: | 1003694068 |
| Provider Name: | MADISON COLCLAZIER RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WI0500X |
| Specialty: | Registered Nurse |
| License Number: | 213924 |
Most Important Dates
| Enumeration Date: | 09/20/2023 |
| Last Updated: | 09/20/2023 |
Provider Practice Location
6128 E 38TH ST
TULSA
OK
741355832
Practice Location Phone/Fax
| Phone: | 5392407461 |
| Fax: |
Provider Mailing Location
6128 E. 38TH ST. TULSA, OK. 74135
TULSA
OK
74135
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |