Individual
MYRA BESS MCKIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2307 SOUTH GORDON COOPER DRIVE, CITIZEN POTAWATOMI NATION/FIRELAKE WELLNESS CENTER, SHAWNEE, OK 74801
(405) 395-9303
(405) 395-9305
Mailing address
P.O. BOX 218, HIGHWAY # 9, TECUMSEH, OK 74873-0218
(405) 395-9303
(405) 395-9305
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
48859
OK
Other
Enumeration date
07/02/2006
Last updated
07/08/2007
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