Individual
LANESHA TIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4901 S PENN AVE, OKLAHOMA CITY, OK 73119-4945
(405) 605-4005
Mailing address
4901 S PENN AVE, OKLAHOMA CITY, OK 73119-4945
(405) 605-4005
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
67180
OK
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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