Individual
KELLIE RENEE SWIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1500 E DOWNING ST STE 102, TAHLEQUAH, OK 74464
(918) 207-0773
(918) 207-0774
Mailing address
PO BOX 751, HULBERT, OK 74441-0751
(918) 772-3390
(918) 431-0203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
74972
OK
Other
Enumeration date
05/14/2014
Last updated
06/04/2019
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