Individual
MISTY MICHELLE WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 540-1511
(918) 542-7374
Mailing address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 540-1511
(918) 542-7374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0118688
OK
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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