Paige Marie Cordova, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L0067313 Issued in OK

Practice address

13 Hillcrest Dr
Ponca City, OK 74604-4808

Phone

(580) 761-5197

NPI assigned

Nov 1, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Paige Marie Cordova Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1861092462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E FRESNO AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012819",
            "telephone_number": "580-716-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 HILLCREST DR",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746044808",
            "telephone_number": "580-761-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "PAIGE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "L0067313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "CORDOVA",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Complete Vision Care, PLLC
• Conhold of Ponca LLC
• Conhold of Ponca, LLC
• Kristy Connell
• Reggie Cooley, DDS
• Andrew Coufal, OD
• Geoffrey H. Cowan, LICENSED COUNSELOR
• Amy Christine Cox, LPC
• Jerimy Todd Cox, D.C.
• Lottie Craig

• Licensed Practical Nurse in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.