Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 251S00000 | OK |
NPI | 1285915710 |
---|---|
Provider Name | Ms. Gloria P Okelley |
First Address | Oklahoma City, OK 73139 |
Second Address | Oklahoma City, OK 73118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2011 |
Last Update Date | 29/08/2011 |