Individual
KELSEY HARTGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4901 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73119-4945
(405) 605-4005
Mailing address
4901 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73119-4945
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0068250
OK
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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