Individual
CARRIE LEIGH HANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
24854 S 470 RD, TAHLEQUAH, OK 74464-1518
(918) 457-9618
Mailing address
24854 S 470 RD, TAHLEQUAH, OK 74464-1518
(918) 457-9618
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0069585
OK
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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