Lauren Runquist
Individual provider Active NPI Athletic Trainer · Tulsa, OH
NPI 1780140293 · NPPES record last updated May 1, 2020
Key facts
- NPI
- 1780140293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 121 North Ave
Tulsa, OH 74101 - Phone
- (763) 485-1232
- NPI assigned
- Feb 20, 2019
- Reactivated
- May 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
121 North Ave
Tulsa, OH 74101
Mailing address
121 North Ave
Tulsa, OK 74101-2398
Phone (782) 098-9876
Other providers in Tulsa, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.