Individual
JUDY PEARCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
51762
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200003810B
—
OK
Enumeration date
06/16/2005
Last updated
11/19/2021
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