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General NPI Number Information
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NPI Number | 1801915566
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Entity Type | Individual
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Provider Name | DAVID ALLEN HENRY RN
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 900 E MAIN ST
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City | NORMAN
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State | OK
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Zip | 73071-5305
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Country | US
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Telephone | 405-573-6467
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 E ETOWAH RD
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City | NOBLE
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State | OK
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Zip | 73068-8464
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Country | US
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Telephone | 405-872-9631
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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 | R0056779
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License Number State | OK
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