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NPI Code Detail

MEDICARE: ANDREA L HURLOCKER

MEDICARE:   ANDREA L HURLOCKER
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
1171M00000XCase Manager/Care CoordinatorW083210733OK

General Provider Information

NPI Number : 1548192503
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA L HURLOCKER
Provider Business Mailing Address
First Line : 1108 N WHEELER AVE
Second Line :
City : SALLISAW
State : OK
Zip : 74955-2227
Country : US
Telephone Number : 918-775-5513
Fax Number :
Provider Business Practice Location Address
First Line : 1108 N WHEELER AVE
Second Line :
City : SALLISAW
State : OK
Zip : 74955-2227
Country : US
Telephone Number : 918-775-5513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ ANDREA L HURLOCKER ” Practice Location

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