Individual
MRS. ANGELA M ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 878-4693
(405) 878-4690
Mailing address
PO BOX 622, NEWALLA, OK 74857-0622
(405) 878-4693
(405) 878-4690
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0050173
OK
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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