Amber R Odom-Sullivan

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

NPI 1407448368 · NPPES record last updated Feb 10, 2021

Key facts

NPI
1407448368
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
202 S Washita Ave
Wynnewood, OK 73098-7820
Phone
(405) 665-4385
NPI assigned
Feb 10, 2021
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

202 S Washita Ave
Wynnewood, OK 73098-7820

Mailing address

1420 E Jennings St
Wynnewood, OK 73098-1020
Phone (405) 207-8510

Other providers in Wynnewood, OK

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

Sources for this page

Verify at the official NPI Registry.