Individual
KAMI SUE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
859 E MELTON DR, JAY, OK 74346-2704
(918) 253-1700
Mailing address
859 E MELTON DR, JAY, OK 74346-2704
(918) 253-1740
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0134475
OK
164W00000X
Licensed Practical Nurse
65518
OK
Other
Enumeration date
07/19/2018
Last updated
04/23/2021
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