Individual
LISA LOUISE KIDDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 781-3622
Mailing address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 781-3622
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R0058013
OK
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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