Individual
HEATHER KINKAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 DRAKE LN, PONCA CITY, OK 74604-2749
(918) 331-8342
Mailing address
2320 DRAKE LN, PONCA CITY, OK 74604-2749
(918) 331-8342
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0068393
OK
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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