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NPI Code Detail

MEDICARE: JOYCE WHITE

MEDICARE: JOYCE WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1164990644
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCE WHITE
Provider Business Mailing Address
First Line : PO BOX 1356
Second Line :
City : FORT GIBSON
State : OK
Zip : 74434-1356
Country : US
Telephone Number : 918-680-0141
Fax Number : 918-478-3079
Provider Business Practice Location Address
First Line : 500 ROSS AVE
Second Line :
City : FORT GIBSON
State : OK
Zip : 74434-8422
Country : US
Telephone Number : 918-680-0141
Fax Number : 918-478-3079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2018
Last Update Date : 11/02/2018

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Directions to “ JOYCE WHITE ” Practice Location

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