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Individual

MRS. KATHY C DAVENPORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP-BC

Contact information

Practice address
1609 N STRONG BLVD STE 300, MCALESTER, OK 74501-3881
(918) 423-3400
(918) 420-5051
Mailing address
PO BOX 1146, 1609 N STRONG BLVD SUITE 300, MCALESTER, OK 74502-1146
(918) 423-3400
(918) 420-5051

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R0044227
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
444864239001
BLUE CROSS/BLUE SHIELD
Enumeration date
10/18/2006
Last updated
02/28/2008
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