Individual
MRS. DORTHINE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5550 S GARNETT RD, TULSA, OK 74146-6831
(918) 665-2501
Mailing address
13209 E 38TH ST, TULSA, OK 74134-5205
(918) 280-0820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0020335
OK
Other
Enumeration date
02/11/2012
Last updated
02/11/2012
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