Individual
MRS. LEESA HERRMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
112 MCKINLEY AVE, CHANDLER, OK 74834-1622
(405) 258-3040
Mailing address
312 W 2ND ST, CHANDLER, OK 74834-2065
(405) 258-5439
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0020159
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L0020159
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
09/02/2006
Last updated
07/08/2007
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