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NPI Code Detail

MEDICARE: DEANDRA R HUNIGAN

MEDICARE: DEANDRA R HUNIGAN
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659654275
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANDRA R HUNIGAN
Provider Business Mailing Address
First Line : 2625 N PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-2512
Country : US
Telephone Number : 918-749-0149
Fax Number : 918-794-0196
Provider Business Practice Location Address
First Line : 2625 N PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74106-2512
Country : US
Telephone Number : 918-749-0149
Fax Number : 918-794-0196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2011
Last Update Date : 09/20/2011

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Directions to “ DEANDRA R HUNIGAN ” Practice Location

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