Individual
KELLIE DANIELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4510 NW 39TH ST, OKLAHOMA CITY, OK 73122-2503
(405) 759-4300
Mailing address
4510 NW 39TH ST, OKLAHOMA CITY, OK 73122-2503
(843) 929-2590
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216046
OK
363LP2300X
Primary Care Nurse Practitioner
25717
SC
Other
Enumeration date
01/12/2022
Last updated
09/03/2024
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