Individual
MARIAH ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
655 E OKMULGEE ST, MUSKOGEE, OK 74403-5529
(918) 869-8636
Mailing address
4421 DENISON ST, MUSKOGEE, OK 74401-1518
(918) 869-8636
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
02635
OK
164W00000X
Licensed Practical Nurse
61050
OK
Other
Enumeration date
03/03/2013
Last updated
05/14/2026
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