Individual provider · NPI-1

Souliya Scott Chan, RN

Registered Nurse, General Practice · Oklahoma City, OK

NPI number1689395402
StatusActive
Last updated in NPPESSep 9, 2022

Details

NPI
1689395402
Entity type
Individual (NPI-1)
Name
Souliya Scott Chan
Credential
RN
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 9, 2022
Certification date
Sep 9, 2022
Last updated
Sep 9, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General PracticeR0067678OKYes

Practice location

921 Ne 13th St
Oklahoma City, OK 73104-5007

Phone 405-456-1000

Mailing address

4206 Ne 33rd St
Oklahoma City, OK 73121-5629

Phone 405-306-4978

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