Individual
CARLY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3417 WELLINGTON RD, PONCA CITY, OK 74604-1676
(580) 767-9493
Mailing address
3417 WELLINGTON RD, PONCA CITY, OK 74604-1676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0078876
OK
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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