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General NPI Number Information
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NPI Number | 1760749188
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Entity Type | Individual
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Provider Name | SANDRA CARTLIDGE RN
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Gender | Female
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 303 E COURT ST
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City | ATOKA
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State | OK
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Zip | 74525-2047
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Country | US
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Telephone | 580-889-3399
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Fax | 580-889-3887
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Provider Business Mailing Address
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Address Line | 750 S PECAN
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City | LANE
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State | OK
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Zip | 74555-1920
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Country | US
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Telephone | 582-239-1789
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Fax | 580-889-3887
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | R75344
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License Number State | OK
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