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NPI Code Detail

MEDICARE: JOY LANAE ELDER

MEDICARE: JOY LANAE ELDER
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
2175T00000XPeer SpecialistOK
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1770304644
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY LANAE ELDER
Provider Business Mailing Address
First Line : 1724 NW 4TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-2609
Country : US
Telephone Number : 405-318-8090
Fax Number :
Provider Business Practice Location Address
First Line : 1724 NW 4TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-2609
Country : US
Telephone Number : 405-318-8090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2024
Last Update Date : 04/02/2025

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Directions to “ JOY LANAE ELDER ” Practice Location

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