Individual
KALA MARIE GAYDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
3336 E 32ND ST STE 220, TULSA, OK 74135
(918) 398-0800
(918) 398-0800
Mailing address
10512 N 110TH EAST AVE STE 220, OWASSO, OK 74055-6638
(918) 376-8830
(918) 376-8839
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
96559
OK
363LF0000X
Family Nurse Practitioner
820817
TX
363LP2300X
Primary Care Nurse Practitioner
96559
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200772750A
—
OK
Enumeration date
02/18/2012
Last updated
01/15/2019
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