Andrea Boles

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

NPI 1609568757 · NPPES record last updated May 25, 2023

Key facts

NPI
1609568757
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
128 N 12TH Ave
Durant, OK 74701-4718
Phone
(580) 745-9276
NPI assigned
May 25, 2023
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OK Yes

Addresses

Primary practice location

128 N 12TH Ave
Durant, OK 74701-4718

Mailing address

16980 Rainbow LN
Madill, OK 73446-3075
Phone (580) 371-1894

Other providers in Durant, OK

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

Sources for this page

Verify at the official NPI Registry.