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Individual

MR. JODY WAYNE ARDREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP-CNP

Contact information

Practice address
905 COLONY DR, ADA, OK 74820-2329
(580) 436-5111
(580) 436-1159
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-2362

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
79784
OK

Other

Enumeration date
09/17/2010
Last updated
11/19/2021
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