Individual
MISS KYLIE MISHAEL SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
1001 W MAIN ST, DURANT, OK 74701-5038
(580) 924-7330
Mailing address
82 BLUE STEM ROAD, CADDO, OK 74729-3019
(580) 434-2719
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 0110761
OK
Other
Enumeration date
03/24/2015
Last updated
09/21/2017
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