Healthcare Provider Details

I. General information

NPI: 1487290425
Provider Name (Legal Business Name): MRS. ANNA ELLEN SILVERHORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 SW 38TH ST
LAWTON OK
73505-6912
US

IV. Provider business mailing address

602 SW 38TH ST
LAWTON OK
73505-6912
US

V. Phone/Fax

Practice location:
  • Phone: 580-248-5780
  • Fax: 405-366-0400
Mailing address:
  • Phone: 580-248-5780
  • Fax: 405-366-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: