Unknown Individual – Nurse Practitioner, NPI 1629252846

Unknown Individual is a healthcare provider. based in Poteau, Oklahoma. specializing in Nurse Practitioner. They hold a License No. 77294 (OK). The NPI Number for Unknown Individual is 1629252846

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629252846
Phone
(918) 647-8635
Address
105 WALL ST
Deactivation Date
26 February 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 105 WALL ST

    POTEAU, OK 749534433

    Phone: (918) 647-8635

    Fax: (918) 635-3191

    Type: Location

  • PO BOX 689

    POTEAU, OK 749530689

    Phone: (918) 647-8635

    Fax: (918) 635-3191

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74953)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1629252846.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Poteau, Oklahoma in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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