Individual
TERICKA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5200 E I 240 SERVICE RD, OKLAHOMA CITY, OK 73135-2610
(580) 284-5255
Mailing address
11501 N ANN ARBOR AVE, OKLAHOMA CITY, OK 73162-3735
(580) 284-5255
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG08180037
OK
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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