Individual
MS. ASHLEY ANN BAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
Mailing address
1311 W CHOCTAW ST, TAHLEQUAH, OK 74464-3421
(918) 207-9563
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0071379
OK
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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