Individual
CAMMIE LADAWN WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1500 COOKSON DR, PONCA CITY, OK 74604-4109
(580) 977-8684
Mailing address
1500 COOKSON DR, PONCA CITY, OK 74604-4109
(580) 977-8684
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0071717
OK
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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