Wennie Mae Agbale
Individual provider Active NPI Driver · Moore, OK
NPI 1538048491 · NPPES record last updated Sep 9, 2025
Key facts
- NPI
- 1538048491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 1309 SW 25TH St
Moore, OK 73170-7558 - Phone
- (952) 393-6271
- NPI assigned
- Aug 27, 2025
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | Yes |
Addresses
Primary practice location
1309 SW 25TH St
Moore, OK 73170-7558
Mailing address
1309 SW 25TH St
Moore, OK 73170-7558
Phone (952) 393-6271
Other providers in Moore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.