KIMMIE PHISAIWATH

OKLAHOMA CITY, OK
NPI1639662216
Former NamePHUONG NGUYEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: OK  pending)
Enumeration Date2018-06-08
Last Update Date2020-06-12
Business Address
KIMMIE PHISAIWATH
9315 S PENNSYLVANIA AVE STE A
OKLAHOMA CITY, OK 73159-6940
Phone number: 405-691-9004
Mailing Address
KIMMIE PHISAIWATH
9315 S PENNSYLVANIA AVENUE SUITE A
OKLAHOMA CITY, OK 73159
Phone number: 405-691-9004
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