Individual
LESTER KEATHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
700 N MAIN ST, GORE, OK 74435-2013
(918) 571-2369
Mailing address
109 8TH STREET, GORE, OK 74435
(918) 571-2369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
103738
OK
Other
Enumeration date
02/07/2012
Last updated
08/18/2020
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