Cortez De'Angelo Edwards
Individual provider Active NPI Case Manager/Care Coordinator · Wagoner, OK
NPI 1699204792 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1699204792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 26243 Highway 51
Wagoner, OK 74467-8740 - Phone
- (918) 614-0778
- NPI assigned
- Jun 12, 2017
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
26243 Highway 51
Wagoner, OK 74467-8740
Mailing address
26243 Highway 51
Wagoner, OK 74467-8740
Phone (918) 614-0778
Other providers in Wagoner, OK
- Carrie Dumond
- Lori Dyer
- Eagle Ridge Institute
- Eagle Ridge Institute
- Ashley Ann Edwards
- Melissa Ellis
- Emerald First Choice Hospice LLC
- Jeffrey K Evans
- Mylinda Renee Fanj
- Elizabeth Farar
All providers in Wagoner, OK · Case Manager/Care Coordinator in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. 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.