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General NPI Number Information
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NPI Number | 1629997663
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARE COORDINATION, PLLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 6314 E 89TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-8562
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Country | US
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Telephone | 918-257-6629
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Fax | 918-398-9262
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Provider Business Mailing Address
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Address Line | 6314 E 89TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-8562
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Country | US
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Telephone | 918-257-6629
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Fax | 918-398-9262
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Authorized Official
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Title or Position | APRN-CNP
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Name | DR. CHELSEA LYNN RIDENER
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Credential | DNP
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Telephone | 254-592-0895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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