Individual
KELLY NESDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1503 S MISSION ST STE A, ANADARKO, OK 73005-5815
(405) 247-1100
Mailing address
1216 SW 158TH ST, OKLAHOMA CITY, OK 73170-3516
(405) 541-0665
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112029
OK
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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