Lacey Layne Bernheisel

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

NPI 1306523980 · NPPES record last updated Jul 5, 2023

Key facts

NPI
1306523980
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
619 N Main St
Muskogee, OK 74401-4431
Phone
(918) 682-8407
NPI assigned
Jul 5, 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

619 N Main St
Muskogee, OK 74401-4431

Mailing address

619 N Main St
Muskogee, OK 74401-4431

Other providers in Muskogee, OK

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

Sources for this page

Verify at the official NPI Registry.