Individual
JANSON P VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
400 S GRAND ST, CRESCENT, OK 73028-9118
(405) 969-2818
Mailing address
400 S GRAND ST, CRESCENT, OK 73028-9118
(405) 969-2818
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
92801
OK
363LF0000X
Family Nurse Practitioner
Primary
92801
OK
Other
Enumeration date
09/17/2013
Last updated
05/25/2022
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