Individual
KELLY K KOZHULENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2409 NW 172ND CIR, EDMOND, OK 73012-0010
(405) 227-3130
Mailing address
2409 NW 172ND CIR, EDMOND, OK 73012-0010
(405) 227-3130
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
205825
OK
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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