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Individual

ALICIA CHILDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
RR 2 BOX 7155, WESTVILLE, OK 74965-9433
(918) 723-3997
(918) 723-3889
Mailing address
PO BOX 751, HULBERT, OK 74441-0751
(918) 772-3390
(918) 772-3638

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57828
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57828
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
12/23/2015
Last updated
12/23/2015
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