Provider Demographics
NPI:1548018955
Name:JAMES, FLETCHER WAYNE (LPN)
Entity type:Individual
Prefix:MR
First Name:FLETCHER
Middle Name:WAYNE
Last Name:JAMES
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 S 88TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1533
Mailing Address - Country:US
Mailing Address - Phone:539-292-0106
Mailing Address - Fax:
Practice Address - Street 1:3843 S 88TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1533
Practice Address - Country:US
Practice Address - Phone:539-292-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK200232164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse