Individual
CHELSEA AGENT REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
1015 E CHOCTAW AVE, SALLISAW, OK 74955-5011
(918) 774-0034
Mailing address
1015 E CHOCTAW AVE, SALLISAW, OK 74955-5011
(918) 774-0034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
109534
OK
163W00000X
Registered Nurse
R096514
AR
363LF0000X
Family Nurse Practitioner
Primary
109534
OK
363LF0000X
Family Nurse Practitioner
A005342
AR
Other
Enumeration date
04/25/2017
Last updated
12/21/2018
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