| Ltcnp | |
|
14355 W Crescent Dover Rd Crescent OK 73028 | |
| (405) 650-5561 | |
| (405) 400-2559 |
| Full Name | Ltcnp |
|---|---|
| Speciality | Clinic/Center |
| Location | 14355 W Crescent Dover Rd, Crescent, Oklahoma |
| Authorized Official Name and Position | Shannon Dunn (OWNER) |
| Authorized Official Contact | 4055605561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ltcnp 14355 W Crescent Dover Rd Crescent OK 73028 Ph: () - | Ltcnp 14355 W Crescent Dover Rd Crescent OK 73028 Ph: (405) 650-5561 |
| NPI Number | 1154030724 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 11/22/2022 |
| Medicare PECOS PAC ID | 7911362645 |
|---|---|
| Medicare Enrollment ID | O20230502000405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154030724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Shannon Lee Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972272490 PECOS PAC ID: 2668731720 Enrollment ID: I20211108000600 |
Center For Internal Medicine And Pediatrics - Crescent Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Grand, Crescent, OK 73028 Phone: 405-969-2818 | |
Mercy Hospital Logan County Crescent Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 S Grand, Crescent, OK 73028 Phone: 405-969-2818 |