Individual
MATTIE LETHERMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1220 N FLORENCE AVE, CLAREMORE, OK 74017-4381
(918) 341-5311
Mailing address
4937 S QUINCY AVE, TULSA, OK 74105-4730
(620) 515-4814
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
214829
OK
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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