Individual
MARY KEKAHBAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
129 CONNER RD, HOMINY, OK 74035-2100
(918) 594-1300
Mailing address
1121 ROGERS AVE, PAWHUSKA, OK 74056-3046
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AG02200097
OK
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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