Individual
KETTI LYNN EDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
105 E INDUSTRIAL RD STE B, GUTHRIE, OK 73044-6971
(405) 919-7570
(405) 256-9748
Mailing address
1603 HUNTERS PATH, EDMOND, OK 73034-1627
(405) 919-7570
(405) 256-9748
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0074528
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200057880A
—
OK
Enumeration date
07/12/2005
Last updated
09/25/2021
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