Individual
HANNAH GRACE ROYALTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(405) 271-5781
Mailing address
900 NE 122ND ST APT 907, OKLAHOMA CITY, OK 73114-9100
(205) 873-5876
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4735
OK
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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