Individual
KEELY NICOLE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18503 N PORTLAND AVE, EDMOND, OK 73012-9149
(405) 531-4271
Mailing address
18503 N PORTALND AVE, EDMOND, OK 73012
(405) 531-4271
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206791
OK
Other
Enumeration date
02/18/2022
Last updated
07/25/2022
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