Individual
MARY BILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W MAIN ST, DURANT, OK 74701-5038
(580) 924-7330
Mailing address
1001 W MAIN ST, DURANT, OK 74701-5038
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
370244121099
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
09/29/2011
Last updated
09/29/2011
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