Nicholena Angelique Neubauer
Individual provider Active NPI Peer Specialist · Okemah, OK
NPI 1104408079 · NPPES record last updated Apr 21, 2021
Key facts
- NPI
- 1104408079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 209 W Broadway St
Okemah, OK 74859-2618 - Phone
- (918) 650-8561
- NPI assigned
- Apr 21, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
209 W Broadway St
Okemah, OK 74859-2618
Mailing address
209 W Broadway St
Okemah, OK 74859-2618
Phone (918) 650-8561
Other providers in Okemah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.