Candice Brown

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

NPI 1922535707 · NPPES record last updated May 11, 2017

Key facts

NPI
1922535707
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
109 S Harrill Ave
Wagoner, OK 74467-5317
Phone
(918) 485-0242
Fax
(918) 485-0204
NPI assigned
May 11, 2017
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

Specialties & licenses

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

Addresses

Primary practice location

109 S Harrill Ave
Wagoner, OK 74467-5317

Mailing address

109 S Harrill Ave
Wagoner, OK 74467-5317
Phone (918) 485-0242

Other providers in Wagoner, OK

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

Sources for this page

Verify at the official NPI Registry.