Individual
KYLIE ANN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9600 BROADWAY EXT STE B103, OKLAHOMA CITY, OK 73114-7408
(405) 715-3610
(405) 715-3612
Mailing address
PO BOX 13618, OKLAHOMA CITY, OK 73113-1618
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
115153
OK
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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