Provider Demographics
NPI:1063995363
Name:DEMOSS, ANNABELLE MORGAN (CPM)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:MORGAN
Last Name:DEMOSS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 S ROLLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-4811
Mailing Address - Country:US
Mailing Address - Phone:502-759-7299
Mailing Address - Fax:
Practice Address - Street 1:3610 S ROLLING OAKS DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-4811
Practice Address - Country:US
Practice Address - Phone:502-759-7299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty