Provider Demographics
NPI:1558607804
Name:TANNER, KARI DAWN (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:DAWN
Last Name:TANNER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:MRS
Other - First Name:KARI
Other - Middle Name:DAWN
Other - Last Name:TANNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA/L
Mailing Address - Street 1:16412 S 4415 RD
Mailing Address - Street 2:
Mailing Address - City:BLUEJACKET
Mailing Address - State:OK
Mailing Address - Zip Code:74333-4341
Mailing Address - Country:US
Mailing Address - Phone:918-704-3460
Mailing Address - Fax:
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7736
Practice Address - Fax:918-540-7739
Is Sole Proprietor?:No
Enumeration Date:2012-12-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1072224Z00000X
OK6011225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant