Crysta Nicole Cunningham

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

NPI 1700523883 · NPPES record last updated May 19, 2022

Key facts

NPI
1700523883
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1015 W Washbourne St
Jay, OK 74346-4205
Phone
(918) 308-5513
NPI assigned
May 19, 2022
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 Yes

Addresses

Primary practice location

1015 W Washbourne St
Jay, OK 74346-4205

Mailing address

1617 W Atlanta St
Jay, OK 74346-3816
Phone (918) 353-3459

Other providers in Jay, OK

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

Sources for this page

Verify at the official NPI Registry.