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NPI Code Detail

MEDICARE: MIRIAM CLINE

MEDICARE: MIRIAM CLINE
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 : 1568586956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRIAM CLINE
Provider Business Mailing Address
First Line : 724 HEATHER TER
Second Line :
City : YUKON
State : OK
Zip : 73099-3314
Country : US
Telephone Number : 405-694-7575
Fax Number :
Provider Business Practice Location Address
First Line : 7777 E US HIGHWAY 66
Second Line :
City : EL RENO
State : OK
Zip : 73036-9125
Country : US
Telephone Number : 405-422-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 08/05/2015

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Directions to “ MIRIAM CLINE ” Practice Location

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