Individual
GANGA BHAVANI PANDARABOYINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18244 CAMBORNE AVE, EDMOND, OK 73012-3215
(859) 687-5047
Mailing address
18244 CAMBORNE AVE, EDMOND, OK 73012-3215
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
211917
OK
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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