Individual
KELLE R CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9917 SE 15TH ST, MIDWEST CITY, OK 73130-5504
(405) 622-2070
Mailing address
1109 TWISTED OAK DR, MIDWEST CITY, OK 73130-5311
(405) 795-0004
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1551
OK
Other
Enumeration date
03/10/2007
Last updated
12/14/2010
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