Individual
CASSIE GRILLIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 OKLAHOMA AVE, MCALESTER, OK 74501-7520
(918) 423-4905
Mailing address
101 OKLAHOMA AVE, MCALESTER, OK 74501-7520
(405) 503-1003
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95646
OK
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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