Individual
CONNIE LEANN WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMT
Contact information
Practice address
1414 ARLINGTON ST STE 2200, ADA, OK 74820-2694
(580) 399-3594
Mailing address
20379 COUNTY ROAD 1590, ADA, OK 74820-0443
(580) 399-3594
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R0114751
OK
163WE0003X
Emergency Registered Nurse
R0114751
OK
163WM1400X
Nurse Massage Therapist (NMT)
Primary
R0114751
OK
225700000X
Massage Therapist
197627
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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