Individual
KERA MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,CRNA
Contact information
Practice address
920 STANTON L YOUNG BLVD STE 1140, OKLAHOMA CITY, OK 73104-5036
(405) 271-4351
(405) 271-8695
Mailing address
PO BOX 26901, OKLAHOMA CITY, OK 73126-0901
(314) 330-6729
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2016024837
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209395
OK
Other
Enumeration date
03/16/2022
Last updated
08/19/2022
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