Healthcare Provider Details

I. General information

NPI: 1447890488
Provider Name (Legal Business Name): MARIAH LYNN ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27753 S WELLING RD
WELLING OK
74471-2202
US

IV. Provider business mailing address

441155 E HIGHWAY 10
WELCH OK
74369-9337
US

V. Phone/Fax

Practice location:
  • Phone: 918-457-4999
  • Fax:
Mailing address:
  • Phone: 918-961-2755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number314883
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: