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Organization
AETHERIUS MEDICAL LLC
Active
Organization
AETHERIUS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRYSTEN MESCAN (OWNER - FAMILY NURSE PRACTITIONER)
(405) 300-1476
Entity
Organization
Contact information
Practice address
408 N MAIN ST, NOBLE, OK 73068-9574
(405) 339-5261
Mailing address
408 N MAIN ST, NOBLE, OK 73068-9574
(405) 300-1476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/23/2025
Last updated
03/18/2025
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