| NPI | 1811267891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH P WARREN Owner 918-591-3567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 50761) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2019-01-15 |