Pauletta Mae Bearpaw, LPN

Individual provider Active NPI Licensed Practical Nurse · Jay, OK

NPI 1255099552 · NPPES record last updated Dec 3, 2021

Key facts

NPI
1255099552
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L0038508 (OK)
Practice address
859 E Melton Dr
Jay, OK 74346-2704
Phone
(918) 253-4271
Fax
(918) 253-4938
NPI assigned
Dec 3, 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

State licenses

LicenseStateTypeSpecialty
L0038508OKMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L0038508 OK Yes

Addresses

Primary practice location

859 E Melton Dr
Jay, OK 74346-2704

Mailing address

859 E Melton Dr
Jay, OK 74346-2704
Phone (918) 253-4271

Other providers in Jay, OK

All providers in Jay, OK · Licensed Practical Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.