Melissa Gayle Vavricka-conaway, | |
1001 N Country Club Rd, Ada, OK 74820-2847 | |
(580) 421-4570 | |
(580) 421-6283 |
Full Name | Melissa Gayle Vavricka-conaway |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1001 N Country Club Rd, Ada, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992839211 | NPI | - | NPPES |
1179 | Other | OK | STATE LICENSE # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 1179 (Oklahoma) | Primary |
Provider Name | Chickasaw Nation Division Of Health Chickasaw Nation Medical Center |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1255364923 PECOS PAC ID: 8426957523 Enrollment ID: O20040108000364 |
Mailing Address | Practice Location Address |
---|---|
Melissa Gayle Vavricka-conaway, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 | Melissa Gayle Vavricka-conaway, 1001 N Country Club Rd, Ada, OK 74820-2847 Ph: (580) 421-4570 |
Darlene Seck, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1921 Stonecipher Blvd, Ada, OK 74820 Phone: 580-436-3980 Fax: 580-421-6283 | |
Sarah Prater, RD/LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-421-4570 | |
Rachael Edmundson, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 Fax: 580-421-6283 | |
Samikshya Thapa, RD Dietitian Medicare: Medicare Enrolled Practice Location: 430 N Monte Vista St, Ada, OK 74820 Phone: 580-421-1518 Fax: 580-272-1618 | |
Caroline Ng, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 430 N Monte Vista St, Ada, OK 74820 Phone: 580-421-1518 Fax: 580-272-1618 | |
Virginia Austin, RD/LD Dietitian Medicare: Medicare Enrolled Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 | |
Cassandra Star Edwards, M.S., R.D./L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3901 N Broadway Ave, Ada, OK 74820 Phone: 580-371-5183 |