Individual
KATHLEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1011 14TH AVE NW, ER DEPT, ARDMORE, OK 73401-1828
(800) 749-4560
(405) 749-4557
Mailing address
4401 W MEMORIAL RD, STE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4557
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R59329
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100150540A
—
OK
Enumeration date
11/18/2005
Last updated
07/08/2007
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