Whalio Doctors

NPI 1003839911

Billy Jack Premo, CRNA

Practitioner Certified Registered Nurse Anesthetist Midwest City, OK

Practice location

Address
2825 Parklawn Dr, Midwest City, OK 73110-4201
Phone
(405) 360-7576
Mailing address
PO Box 10979, Midwest City, OK 73140-1979

Registered specialties

Certified Registered Nurse Anesthetist Primary
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence R0025846 (OK)

Registry record

NPI
1003839911
Entity type
Individual
Sex (as registered)
Male
NPI issued
25 Jul 2006
Record last updated
12 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.