Individual
MICHELE CLYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 715-3610
Mailing address
PO BOX 13618, OKLAHOMA CITY, OK 73113-1618
(405) 715-3610
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
73155
OK
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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