Individual
CHRISTINE RENEE PIDCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4121 S VAN BUREN ST, ENID, OK 73703-8559
(580) 231-5939
Mailing address
4121 S VAN BUREN ST, ENID, OK 73703-8559
(580) 231-5939
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
67281
OK
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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