Individual
ANNA NICOLE RAWDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4409 N KICKAPOO AVE STE 121, SHAWNEE, OK 74804-1225
(405) 585-0475
(855) 685-0408
Mailing address
4409 N KICKAPOO AVE STE 121, SHAWNEE, OK 74804-1225
(405) 585-0475
(855) 685-0408
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77066
OK
363LF0000X
Family Nurse Practitioner
R00770066
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200236190A
—
OK
Enumeration date
03/31/2009
Last updated
08/23/2021
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