Individual
MS. CAROLYN A HOMBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
(918) 207-0558
Mailing address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
(918) 207-0558
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
F7244607
OK
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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