Unknown Individual – Nurse Practitioner, NPI 1679684914
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
512, East 24th Street, Tishomingo, Johnston County, Oklahoma, 73460, United States
TISHOMINGO, OK 734603214
Phone: (580) 371-2394
Fax: (580) 371-2638
Type: Location
Tishomingo, Johnston County, Oklahoma, 73460, United States
TISHOMINGO, OK 734600176
Phone: (580) 371-2394
Fax: (580) 371-2638
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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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 ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73460)
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