Individual
SHANDRA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 550-6006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207672
OK
Other
Enumeration date
05/03/2022
Last updated
09/30/2022
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