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General NPI Number Information
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NPI Number | 1649083031
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Entity Type | Organization
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Legal Business Name | IN HOME 2 HEAL LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 56296 E 285 RD STE A
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City | AFTON
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State | OK
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Zip | 74331-8184
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Country | US
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Telephone | 918-219-9189
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Fax |
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Provider Business Mailing Address
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Address Line | 56296 E 285 RD STE A
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City | AFTON
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State | OK
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Zip | 74331-8184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/VP CLINICAL OPERATIONS
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Name | JANNA BAKER
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Credential |
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Telephone | 620-778-5249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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