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1033117072
JEANINE DIANNE DETERDING
PONCA CITY, OK
NPI
1033117072
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: OK R0045604)
Enumeration Date
2005-07-13
Last Update Date
2007-07-08
Business Address
-- JEANINE DIANNE DETERDING ARNP
306 FAIRVIEW AVE
PONCA CITY, OK 74601-2001
Phone number: 580-762-3342
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Mailing Address
-- JEANINE DIANNE DETERDING ARNP
306 FAIRVIEW AVE
PONCA CITY, OK 74601-2001
Phone number: 580-762-3342
Copy
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