Individual
KIMBERLY RENE BUFFALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2104 S MAIN ST, GROVE, OK 74344-5356
(918) 964-7071
(800) 872-8213
Mailing address
2104 S MAIN ST, GROVE, OK 74344-5356
(918) 964-7071
(800) 872-8213
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0080324
OK
363LF0000X
Family Nurse Practitioner
Primary
212781
OK
Other
Enumeration date
08/01/2018
Last updated
05/16/2023
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