Individual
HEATHER RENEE KOGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
27371 S 4410 RD, VINITA, OK 74301-7953
(918) 256-4800
(918) 256-4589
Mailing address
27371 S 4410 RD, VINITA, OK 74301-7953
(918) 256-4800
(918) 256-4589
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0056953
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056953
OKLAHOMA BOARD OF NURSING LICENSE
OK
Enumeration date
01/28/2019
Last updated
01/28/2019
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