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NPI Code Detail

MEDICARE: MRS. ASHLEY LAUREN MALONE

MEDICARE:  MRS. ASHLEY LAUREN MALONE
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1396478574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY LAUREN MALONE
Provider Business Mailing Address
First Line : 13688 S HICKORY ST
Second Line :
City : GLENPOOL
State : OK
Zip : 74033-2842
Country : US
Telephone Number : 918-417-0667
Fax Number :
Provider Business Practice Location Address
First Line : 300 N DENVER AVE
Second Line :
City : TULSA
State : OK
Zip : 74103-1420
Country : US
Telephone Number : 918-596-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2022
Last Update Date : 04/10/2024

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Directions to “ MRS. ASHLEY LAUREN MALONE ” Practice Location

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