Individual
KALEB REDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN FNP
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Mailing address
1201 COVELL VILLAGE DR APT 330, EDMOND, OK 73003-9720
(405) 613-0502
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
113244
OK
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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