Individual provider · NPI-1

Gretchen Michelle Beagles, CCP LP

Perfusionist · Oklahoma City, OK

NPI number1154486629
StatusActive
Last updated in NPPESMar 29, 2011

Details

NPI
1154486629
Entity type
Individual (NPI-1)
Name
Mrs. Gretchen Michelle Beagles
Credential
CCP LP
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 26, 2006
Last updated
Mar 29, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
242T00000X PerfusionistLP63OKYes
247200000X Technician, OtherLP63OK

Practice location

3601 N May Ave
Suite C
Oklahoma City, OK 73112-6641

Phone 405-604-5613 · Fax 405-601-3750

Mailing address

Po Box 12815
Oklahoma City, OK 73157-2815

Phone 405-604-5613 · Fax 405-601-3750

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