Individual provider · Type 1 NPI

Nicole Anastasia Kennetz

Student in an Organized Health Care Education/Training Program · Tulsa, OK

NPI number 1801632138 Active

Practice location

1111 W 17th St
Tulsa, OK 74107-1886

Call (417) 551-2835 Map

Mailing address

903 NE Halifax Pl
Bentonville, AR 72712-8657

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1801632138

Nicole Anastasia Kennetz's National Provider Identifier is 1801632138, issued on Jul 5, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Tulsa, OK. The record was last updated on Jul 5, 2024.