Individual
RAVEN JEANEENE PIONTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, IBCLC
Contact information
Practice address
1202 NW ARLINGTON AVE, LAWTON, OK 73507-6537
(580) 248-2288
(580) 248-5757
Mailing address
619 E SOUTH BOUNDARY ST, WALTERS, OK 73572-2839
(580) 919-5363
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-133766
OK
363LF0000X
Family Nurse Practitioner
Primary
106583
OK
Other
Enumeration date
01/08/2018
Last updated
09/16/2019
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