Individual
KIMBERLY DAWN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9213 NE 10TH ST, MIDWEST CITY, OK 73130-1317
(405) 264-7627
(405) 455-3342
Mailing address
9213 NE 10TH ST, MIDWEST CITY, OK 73130-1317
(405) 264-7627
(405) 455-3342
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
58407
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
463977830
ADULT DAY HEALTH CENTER
OK
Enumeration date
05/16/2019
Last updated
05/16/2019
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