Individual
KELLEY KRISTEEN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10506 S MEMORIAL DR, TULSA, OK 74133-6914
(918) 943-1050
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1996
OK
Other
Enumeration date
04/08/2011
Last updated
12/23/2015
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