Individual
MILTON KEVIN OMONDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-1000
(918) 382-2569
Mailing address
1145 S UTICA AVE STE 110, TULSA, OK 74104-4013
(918) 579-1000
(918) 382-2569
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
101088
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101088
OK STATE LICENXE
OK
Enumeration date
11/07/2017
Last updated
11/07/2017
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