Audra Bean

Individual provider Active NPI Case Manager/Care Coordinator · Tahlequah, OK

NPI 1104514124 · NPPES record last updated Apr 27, 2023

Key facts

NPI
1104514124
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
711 S Muskogee Ave
Tahlequah, OK 74464-4717
Phone
(918) 207-0078
Fax
(918) 207-0558
NPI assigned
Apr 27, 2023
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Mailing address

711 S Muskogee Ave
Tahlequah, OK 74464-4717
Phone (918) 207-0078

Other providers in Tahlequah, OK

All providers in Tahlequah, OK · Case Manager/Care Coordinator in Oklahoma

Sources for this page

Verify at the official NPI Registry.