Individual
KIMBERLY MICHELL SCAGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4657
(580) 332-2323
(580) 421-1384
Mailing address
5630 TRIPLE L RD, DAVIS, OK 73030-9486
(580) 618-2413
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
217660
OK
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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