Individual
CHASITY NICHOLE CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
18824 VEA DR, EDMOND, OK 73012-4007
(580) 504-9526
Mailing address
18824 VEA DR, EDMOND, OK 73012-4007
(580) 504-9526
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
R0123347
OK
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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