Individual
JUSTEENA MELLINE PENDARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1613 SE 66TH ST, OKLAHOMA CITY, OK 73149-5203
(405) 616-3366
Mailing address
19020 SE 29TH ST, HARRAH, OK 73045-6340
(580) 510-9121
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
205767
OK
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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