Individual
DR. DARBY LYNN BALLESTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 577-3000
Mailing address
15646 E 114TH ST N, OWASSO, OK 74055-6120
(918) 409-7998
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
19243
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19243
BOARD OF PHARMACY - OKLAHOMA
OK
Enumeration date
07/21/2021
Last updated
07/21/2021
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