Individual
PEGGY R. TYRRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2505 HUMMINGBIRD LN, PONCA CITY, OK 74604-2818
(580) 765-8863
Mailing address
2505 HUMMINGBIRD LN, PONCA CITY, OK 74604-2818
(580) 765-8863
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0043134
OK
Other
Enumeration date
03/25/2007
Last updated
01/01/2009
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