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General NPI Number Information
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NPI Number | 1386164804
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Entity Type | Individual
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Provider Name | COURTNEY MICHELLE LEVENS
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Gender | Female
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 06/26/2017
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Provider Practice Location Address
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Address Line | 310 1/2 SOUTH 11TH ST.
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City | HARTSHORNE
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State | OK
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Zip | 74547
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Country | US
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Telephone | 918-297-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 607 LEHIGH AVE
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City | HARTSHORNE
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State | OK
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Zip | 74547-3625
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Country | US
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Telephone | 918-297-5979
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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