Individual
CRYSTAL OLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
104 WALL ST, POTEAU, OK 74953-4405
(918) 647-8630
(918) 635-3191
Mailing address
500 S BROADWAY ST, STE D, POTEAU, OK 74953-3819
(918) 564-2270
(877) 210-2506
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
93039
OK
Other
Enumeration date
03/15/2018
Last updated
10/13/2020
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