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Individual

ALEXANDRIA KATELYN CROCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP

Contact information

Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 775-9150
(918) 775-4778
Mailing address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 775-9150
(918) 775-4778

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R09975
AR
363LF0000X
Family Nurse Practitioner
2019007054
MO
363LF0000X
Family Nurse Practitioner
Primary
205372
OK
363LF0000X
Family Nurse Practitioner
A006110
AR
363LF0000X
Family Nurse Practitioner
F02190095
AR

Other

Enumeration date
02/04/2019
Last updated
07/09/2024
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