Individual
PAMELA MICHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1715 N 5TH ST, PONCA CITY, OK 74601-2763
(580) 762-9292
Mailing address
36 RAINTREE ST, PONCA CITY, OK 74604-5412
(580) 761-3139
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200932
OK
Other
Enumeration date
03/10/2021
Last updated
01/24/2023
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