Individual
DESTINY ETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 S OKLAHOMA AVE, CHEROKEE, OK 73728-2545
(580) 596-2800
(580) 596-2805
Mailing address
1111 W 17TH ST, TULSA, OK 74107-1886
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2021
Last updated
02/25/2025
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