Individual
AGBORTAMBENG ENOWEYERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4657
(580) 332-2323
Mailing address
4007 MAGNOLIA RIDGE DR, MELISSA, TX 75454-0314
(405) 881-9965
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
215732
OK
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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