Individual
DR. VANESSA DICUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
20567 E KAMBRIE RD, INOLA, OK 74036-5334
(405) 659-6711
Mailing address
20672 E KAMBRIE RD, INOLA, OK 74036-5349
(405) 659-6711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0122192
OK
Other
Enumeration date
05/12/2021
Last updated
05/12/2022
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