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NPI Code Detail

MEDICARE: CITIZEN POTAWATOMI NATION

MEDICARE: CITIZEN POTAWATOMI NATION
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881981744
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITIZEN POTAWATOMI NATION
Provider Business Mailing Address
First Line : 781 GRAND CASINO BLVD
Second Line :
City : SHAWNEE
State : OK
Zip : 74804-1005
Country : US
Telephone Number : 405-964-5770
Fax Number : 405-964-5783
Provider Business Practice Location Address
First Line : 781 GRAND CASINO BLVD
Second Line :
City : SHAWNEE
State : OK
Zip : 74804-1005
Country : US
Telephone Number : 405-964-5770
Fax Number : 405-964-5785
Authorized Official
Title or Position : DIRECTOR OF HEALTH SERVICES
Name : MR. CHRIS SKILLINGS
Credential :
Telephone Number : 405-964-5770
Provider Enumeration Date : 06/29/2011
Last Update Date : 02/28/2025

Similar Medicare Providers

1932134806 — JAMES G PRISE MD
Practice Location Address:
781 GRAND CASINO BLVD
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax: 405-964-5783
1598053993 — CITIZEN POTAWATOMI NATION WEST CLINIC
Practice Location Address:
781 GRAND CASINO BLVD
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax: 405-964-5785
1548558828 — JEFFERY COLE CATES DPH
Practice Location Address:
781 GRAND CASINO BLVD
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax:
1023352721 — MISS MARY E ZIENTEK RN
Practice Location Address:
781 GRAND CASINO BLVD , CITIZEN POTAWATOMI NATION HEALTH SERVICES
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax: 405-964-5788
1447667225 — MS. ARLENE JAQUEZ LPN
Practice Location Address:
781 GRAND CASINO BLVD
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax: 405-964-5788
1861895518 — CHRISTINE VENCL LPN
Practice Location Address:
781 GRAND CASINO BLVD
SHAWNEE, OK
74804-1005
Practice Phone: 405-964-5770
Practice Fax:

Directions to “CITIZEN POTAWATOMI NATION ” Practice Location

Language Start Address Practice Location
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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