Individual
CHARLSIE RECORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10413 GREENBRIAR PKWY, OKLAHOMA CITY, OK 73159-7656
(405) 691-4665
(405) 378-7628
Mailing address
9101 WOODROW CT, OKLAHOMA CITY, OK 73169-3702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
104700
OK
363LF0000X
Family Nurse Practitioner
Primary
R0104700
OK
Other
Enumeration date
08/08/2017
Last updated
02/24/2026
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