Healthcare Provider Details

I. General information

NPI: 1104235209
Provider Name (Legal Business Name): LINDSEY SCRIBNER CHHA, CNA, LTC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY MOORE CHHA, CNA, LTC

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N WESTERN AVE
TISHOMINGO OK
73460-4824
US

IV. Provider business mailing address

7605 S HOLLOW SPRINGS RD
COLEMAN OK
73432-8660
US

V. Phone/Fax

Practice location:
  • Phone: 580-371-9300
  • Fax:
Mailing address:
  • Phone: 580-224-7849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: