Holly Ann Sutton

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

NPI 1891096293 · NPPES record last updated Dec 15, 2022

Key facts

NPI
1891096293
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
310665 (OK)
Practice address
109 E Ray Fine Blvd
Roland, OK 74954-5198
Phone
(918) 427-3344
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
310665OKMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 310665 OK Yes

Addresses

Primary practice location

109 E Ray Fine Blvd
Roland, OK 74954-5198

Mailing address

109 E Ray Fine Blvd
Roland, OK 74954-5198
Phone (918) 235-4981

Other practice location 1

204 East Choctaw
Sallisaw, OK 74955-7247
Phone (918) 235-4981

Other providers in Roland, OK

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

Sources for this page

Verify at the official NPI Registry.