Individual
KELLEY ANNE DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
401 W MAIN ST, HENRYETTA, OK 74437-4241
(539) 667-0001
Mailing address
401 W MAIN ST, HENRYETTA, OK 74437-4241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1234
OK
Other
Enumeration date
01/22/2024
Last updated
10/06/2025
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