Healthcare Provider Details

I. General information

NPI: 1679090252
Provider Name (Legal Business Name): MEGHAN LAUREN BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9974 E 541 RD
COLCORD OK
74338-2854
US

IV. Provider business mailing address

PO BOX 574
KANSAS OK
74347-0574
US

V. Phone/Fax

Practice location:
  • Phone: 918-314-5751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: