Organization
WHITE LOTUS FAMILY MEDICINE & AESTHETICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY D SMITH (CREDENTIALING SPECIALIST)
(405) 984-7174
Entity
Organization
Contact information
Practice address
1407 E MAIN ST UNIT B, STIGLER, OK 74462-2910
(918) 443-0200
Mailing address
PO BOX 52, STIGLER, OK 74462-0052
(918) 443-0200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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