Individual
PHYLLIS YVONNE GECKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5912 HIGHWAY 70 E, MEAD, OK 73449
(580) 745-9083
(580) 745-9885
Mailing address
1381 SAWMILL RD, DURANT, OK 74701-1008
(580) 920-2819
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24021
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040
—
OK
Enumeration date
08/15/2011
Last updated
08/15/2011
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