Healthcare Provider Details

I. General information

NPI: 1023319753
Provider Name (Legal Business Name): MS. ELIZABETH SALINAS NEWBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2010
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SW 10TH ST
OKLAHOMA CITY OK
73109-5610
US

IV. Provider business mailing address

420 SW 10TH ST
OKLAHOMA CITY OK
73109-5610
US

V. Phone/Fax

Practice location:
  • Phone: 405-236-0701
  • Fax: 405-236-0737
Mailing address:
  • Phone: 405-236-0701
  • Fax: 405-236-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: