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Organization

ELITE RN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA JEANNE ETTER CCNSRX (PRESIDENT)
(580) 402-1635
Entity
Organization

Contact information

Practice address
3568 MCCLAFLIN DR, ENID, OK 73701-7745
(580) 402-1635
(580) 233-2131
Mailing address
PO BOX 3031, ENID, OK 73702-3031
(580) 237-2327
(580) 237-2339

Taxonomy

Speciality
Code
Description
License number
State
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
50268
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200281660A
OK
Enumeration date
07/04/2011
Last updated
07/11/2011
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