MICHELLE L VAN FOSSEN

DURANT, OK
NPI1487925715
Other NameMICHELLE L JENNINGS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OK  2281)
Additional Taxonomies363A00000X Physician Assistant
(Licence: TX  PA07522)
363AM0700X Physician Assistant, Medical
(Licence: OK  2281)
Enumeration Date2012-01-18
Last Update Date2025-01-15
Business Address
MICHELLE L VAN FOSSEN PA-C
1400 BRYAN DR SUITE 303
DURANT, OK 74701-2156
Phone number: 580-931-2227
Mailing Address
MICHELLE L VAN FOSSEN PA-C
HC 71 BOX 157-1
SOPER, OK 74759-9764
Phone number: 210-885-3875