Provider Demographics
NPI:1013123710
Name:MOLLOY KLEIER, KAREE JO (LPN)
Entity Type:Individual
Prefix:
First Name:KAREE
Middle Name:JO
Last Name:MOLLOY KLEIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KAREE
Other - Middle Name:JO
Other - Last Name:KLEIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1607 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-1865
Mailing Address - Country:US
Mailing Address - Phone:918-724-6442
Mailing Address - Fax:918-287-5572
Practice Address - Street 1:627 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-4201
Practice Address - Country:US
Practice Address - Phone:918-287-5645
Practice Address - Fax:918-287-5572
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0022802164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse