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NPI Code Detail

MEDICARE: CASSIE GRILLIOT

MEDICARE: CASSIE GRILLIOT
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
1363LP0200XPediatric Nurse Practitioner95646OK

General Provider Information

NPI Number : 1467911180
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE GRILLIOT
Provider Business Mailing Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 405-503-1003
Fax Number :
Provider Business Practice Location Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 918-423-4905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2019
Last Update Date : 03/13/2019

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Directions to “ CASSIE GRILLIOT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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