Individual
MRS. HARRIET KALIISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1831 E 71ST ST, TULSA, OK 74136-3922
(918) 829-1721
(918) 578-0082
Mailing address
1831 E 71ST ST, TULSA, OK 74136-3922
(918) 829-1721
(918) 578-0082
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
HC8072
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474886124
STATE LICENSE
OK
01
—
HC8072
LPN
OK
Enumeration date
12/13/2017
Last updated
12/13/2017
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