Individual
MRS. ANNA MCKINNIS BEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 WHITE EAGLE DR, PONCA CITY, OK 74601
(580) 765-2510
Mailing address
200 WHITE EAGLE DR, PONCA CITY, OK 74601
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
45750
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45750
LPN
OK
Enumeration date
03/31/2008
Last updated
03/31/2008
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