| NPI | 1174977763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY WAYNE ARDREY Nurse Practitioner 580-279-6413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |