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NPI Code Detail

MEDICARE: KIMBERLY WHEELER

MEDICARE: KIMBERLY WHEELER
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 : 1417357153
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY WHEELER
Provider Business Mailing Address
First Line : 41298 S COUNTY ROAD 266
Second Line :
City : RINGWOOD
State : OK
Zip : 73768-6425
Country : US
Telephone Number : 405-255-1337
Fax Number :
Provider Business Practice Location Address
First Line : 1824 S VAN BUREN ST
Second Line :
City : ENID
State : OK
Zip : 73703-7903
Country : US
Telephone Number : 580-540-8965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2014
Last Update Date : 05/09/2020

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Directions to “ KIMBERLY WHEELER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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