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1109 N Glenn L English St Cordell OK 73632-2007 | |
(580) 832-3339 | |
(580) 832-5076 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1109 N Glenn L English St, Cordell, Oklahoma |
Authorized Official Name and Position | Georganna Lea Buss (CFO) |
Authorized Official Contact | 5807744762 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1220 N Glenn L English St Cordell OK 73632-2010 Ph: (580) 832-3339 | 1109 N Glenn L English St Cordell OK 73632-2007 Ph: (580) 832-3339 |
NPI Number | 1134532344 |
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Provider Enumeration Date | 06/05/2014 |
Last Update Date | 02/17/2022 |
Medicare PECOS PAC ID | 1254239197 |
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Medicare Enrollment ID | O20150216000491 |
Identifier | Type | State | Issuer |
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1134532344 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 2221 (Oklahoma) | Primary |
Provider Name | Lela Dawn Cupp |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1932573490 PECOS PAC ID: 2365740347 Enrollment ID: I20160407000022 |
Provider Name | Aprill Renea Ridgeway |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760953293 PECOS PAC ID: 4385052422 Enrollment ID: I20210409000946 |
Provider Name | Kelsey Schones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912594995 PECOS PAC ID: 2567841539 Enrollment ID: I20220622000353 |
Provider Name | Abby Marie Parker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467104992 PECOS PAC ID: 3173905338 Enrollment ID: I20220804000473 |