Individual
KELLY SUZANNE FALTYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 421-4570
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 421-4570
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
93656
OK
Other
Enumeration date
07/16/2015
Last updated
02/08/2024
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