Individual
MASSEY TAYLOR LEWALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
903 N MAPLE RD, CALUMET, OK 73014-8428
(405) 320-8890
Mailing address
903 N MAPLE RD, CALUMET, OK 73014-8428
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
204252
OK
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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