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1366717134
MITZI GAIL PEMBERTON
PONCA CITY, OK
NPI
1366717134
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OK L0045857)
Enumeration Date
2012-03-13
Last Update Date
2012-03-13
Business Address
-- MITZI GAIL PEMBERTON LPN
1500 N 6TH ST
PONCA CITY, OK 74601-2827
Phone number: 580-763-0931
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Mailing Address
-- MITZI GAIL PEMBERTON LPN
3003 TURNER ST APT B
PONCA CITY, OK 74604-1537
Phone number: 580-763-7171
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