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NPI Code Detail

MEDICARE: MISS ERIKA SHANAE WELLS BS

MEDICARE: MISS ERIKA SHANAE WELLS BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1467594804
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ERIKA SHANAE WELLS BS
Provider Business Mailing Address
First Line : 6100 S WALKER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7026
Country : US
Telephone Number : 405-634-4400
Fax Number : 405-632-1976
Provider Business Practice Location Address
First Line : 6100 S WALKER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7026
Country : US
Telephone Number : 405-634-4400
Fax Number : 405-632-1976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 12/11/2014

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