Individual
KELLY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
11911 S MEMORIAL DR, BIXBY, OK 74008-2030
(918) 943-3790
(918) 943-3793
Mailing address
PO BOX 334, BIXBY, OK 74008-0334
(918) 970-4719
(918) 970-4008
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
96367
OK
Other
Enumeration date
12/05/2019
Last updated
06/08/2023
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