Ashtyn Denee Thomas
Individual provider Active NPI Licensed Practical Nurse · Lenapah, OK
NPI 1689401804 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1689401804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 218471 (OK)
- Practice address
- 11499 NS 413 Rd
Lenapah, OK 74042-3349 - Phone
- (918) 467-0086
- NPI assigned
- Sep 19, 2024
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218471 | OK | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 218471 | OK | Yes |
Addresses
Primary practice location
11499 NS 413 Rd
Lenapah, OK 74042-3349
Mailing address
11499 NS 413 Rd
Lenapah, OK 74042-3349
Phone (918) 467-0086
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. 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.