Individual
KATHERINE MONETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
3751 N ASPEN AVE, BROKEN ARROW, OK 74012-1109
(918) 355-2317
Mailing address
3751 N ASPEN AVE, BROKEN ARROW, OK 74012-1109
(918) 355-2317
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19037
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19037
PHARMACY LICENSE
OK
Enumeration date
11/05/2020
Last updated
11/05/2020
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