Individual
ANDREA DAWN COLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
46198 DEADEND LN, HEAVENER, OK 74937-8244
(254) 498-8574
Mailing address
46198 DEADEND LN, HEAVENER, OK 74937-8244
(254) 498-8574
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
205839
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205839
APRN LICENSE
OK
Enumeration date
01/27/2022
Last updated
01/27/2022
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