Kassandra Jo Brenneman

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

NPI 1295590933 · NPPES record last updated Feb 20, 2024

Key facts

NPI
1295590933
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
23 E Ross Ave
Sapulpa, OK 74066-6423
Phone
(918) 227-2016
NPI assigned
Feb 20, 2024
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

23 E Ross Ave
Sapulpa, OK 74066-6423

Mailing address

23 E Ross Ave
Sapulpa, OK 74066-6423
Phone (918) 227-2016

Other providers in Sapulpa, OK

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

Sources for this page

Verify at the official NPI Registry.