Individual
ALLYN ELISE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1214 ARLINGTON ST, ADA, OK 74820-4045
(580) 436-5111
Mailing address
2701 SW CORNELL AVE, LAWTON, OK 73505-7121
(580) 248-0696
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207381
OK
363LP0200X
Pediatric Nurse Practitioner
207381
OK
Other
Enumeration date
05/02/2022
Last updated
03/11/2024
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