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General NPI Number Information
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NPI Number | 1225473531
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Entity Type | Individual
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Provider Name | EVELYN ANGIE MCELRATH I RDH
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Gender | Female
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 105365 S. HWY 102
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City | MCLOUD
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State | OK
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Zip | 74851
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Country | US
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Telephone | 405-964-2081
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Fax | 405-964-2903
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Provider Business Mailing Address
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Address Line | 26 NORTHWOOD DR
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City | SHAWNEE
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State | OK
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Zip | 74804-9545
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Country | US
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Telephone | 405-596-3600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1359
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License Number State | OK
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