| NPI | 1164582599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY BAKER Provider 580-323-1937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 18658) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK R0057523) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2025-09-11 |