KELLY RAE GOODWIN

CHOCTAW, OK
NPI1841761798
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: FL  AG12180060)
Enumeration Date2018-12-17
Last Update Date2022-03-29
Business Address
KELLY RAE GOODWIN APRN
14543 LARRY ST
CHOCTAW, OK 73020-8569
Phone number: 405-568-9165
Mailing Address
KELLY RAE GOODWIN APRN
14543 LARRY ST
CHOCTAW, OK 73020-8569
Phone number: 405-568-9165
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