Individual
DEKISHA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 W 11TH ST, TULSA, OK 74127-9014
(918) 921-3200
Mailing address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60677
OK
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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