Individual
AUDRA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804
(405) 947-5770
Mailing address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 947-5770
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0062914
OK
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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