MEDICARE: MS. ADRIENNE CRYSTAL GARVEY BACHELORS OF SCIENCE

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1780707331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADRIENNE CRYSTAL GARVEY BACHELORS OF SCIENCE

Provider Business Mailing Address
First Line	:	3100 MEDICAL PKWY
Second Line	:
City	:	CLAREMORE
State	:	OK
Zip	:	74017-1088
Country	:	US
Telephone Number	:	918-342-0770
Fax Number	:	918-342-0087

Provider Business Practice Location Address
First Line	:	3100 MEDICAL PKWY
Second Line	:
City	:	CLAREMORE
State	:	OK
Zip	:	74017-1088
Country	:	US
Telephone Number	:	918-342-0770
Fax Number	:	918-342-0087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	09/07/2022

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