Provider Demographics
NPI:1114762762
Name:HOWRY, MIKAYLA DAWN
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:DAWN
Last Name:HOWRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27154 NUBBIN RDG
Mailing Address - Street 2:
Mailing Address - City:BOKOSHE
Mailing Address - State:OK
Mailing Address - Zip Code:74930-2519
Mailing Address - Country:US
Mailing Address - Phone:918-721-1918
Mailing Address - Fax:
Practice Address - Street 1:1111 W 17TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-1886
Practice Address - Country:US
Practice Address - Phone:918-561-8324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program