Individual
CARMON ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6658
Mailing address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6658
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
56857
OK
Other
Enumeration date
08/06/2015
Last updated
03/06/2018
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