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NPI Code Detail

MEDICARE: MRS. TOSHA LYNN BYRD CM

MEDICARE:  MRS. TOSHA LYNN BYRD  CM
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 CoordinatorCERTIFICATE # 8107OK

General Provider Information

NPI Number : 1861722696
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TOSHA LYNN BYRD CM
Provider Business Mailing Address
First Line : 1104 S AVERY DR
Second Line :
City : MOORE
State : OK
Zip : 73160-7029
Country : US
Telephone Number : 405-604-9644
Fax Number : 405-604-9689
Provider Business Practice Location Address
First Line : 301 W I 240 SERVICE RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7701
Country : US
Telephone Number : 405-604-9644
Fax Number : 405-604-9689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2009
Last Update Date : 12/29/2009

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Directions to “ MRS. TOSHA LYNN BYRD CM” Practice Location

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